Physical Activity and Mental Disorder Among Adolescents in the United States

To estimate associations between physical activity (PA) and a broad range of lifetime mental disorders among adolescents, and to evaluate whether the context of sports participation impacts these associations.

The sample included 6,483 13-18 year-olds from the National Comorbidity Survey Adolescent Supplement. Adolescents completed face-to-face psychiatric interviews and a parent provided diagnostic and other family-level information on the participating adolescent by completing a self-administered questionnaire. PA was measured by adolescent self-report and dichotomized to indicate vigorous exercise several times a week. Nineteen psychiatric disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria. Multiple logistic regression analyses were used to estimate associations of PA with mental disorders, suicidality, and psychological distress.

Two thirds of adolescents reported being physically active. Active adolescents had significantly lower odds of mood disorder (Odds ratio[OR] = .74, 95% confidence interval [CI]=.58-.94), bipolar II disorder (OR = .54, 95% CI=.30-.99), and general psychological distress (OR = .71, 95% CI=.52-.96) than less/inactive adolescents. In contrast, adolescents who engaged in PA were more likely to have lifetime alcohol use disorder (OR = 1.78, 95% CI = 1.11-2.85), bulimia (OR = 5.84, 95% CI = 2.48-13.79), generalized anxiety disorder (OR = 2.04, 95% CI = 1.16-3.58), and posttraumatic stress disorder (OR = 1.65, 95% CI = 1.07-2.55). The direct associations between PA and alcohol use disorder and bulimia appeared to be specific to adolescents who participated in organized sports.

Associations between PA and lifetime mental disorder among adolescents may differ according to both disorder type and the context in which PA occurs. Longitudinal studies that assess the context of PA may be able to explain apparent discrepant associations between PA and mental disorder.