Do lifestyle risk behaviors affect anxiety, depressive symptoms, and suicidal ideation among adolescents?

Cultivating and maintaining good mental health and a healthy lifestyle during adolescence-the period when physical and psychological development occurs-is important. Further, an unhealthy lifestyle can have long-term effects on health. Few studies have examined the multiple effects of lifestyle risk behavior on mental health, and the behaviors that interact with this relationship remain unclear. This study aimed to explore the associations between anxiety, depressive symptoms, and suicidal ideation and a cumulative unhealthy lifestyle. The study included 54,948 participants from the 2020 Korea Youth Risk Behavior Web-Based Survey. The generalized anxiety disorder-7 scale was used to define the disorder. Depressive symptoms and suicidal ideation were evaluated using a self-reported questionnaire. The relationship between mental health and lifestyle risk scores was examined using multiple logistic regression analysis. There was a significantly positive relationship of a high lifestyle risk score with the risk of generalized anxiety disorder, depressive symptoms, and suicidal ideation. There were interaction effects between sex and academic achievement. Insufficient/prolonged sleep was strongly associated with poor mental health among Korean adolescents. Our findings showed an association between poor mental health and high lifestyle risk scores. Longitudinal studies to identify potential risk behaviors and to reveal causal relationships are warranted.