title: Sit, step, sweat: longitudinal associations between physical activity patterns, anxiety and depression.
abstract: BACKGROUND
  Physical inactivity has been identified as a risk factor for depression and, less often, as a long-term consequence of depression. Underexplored is whether similar bi-directional longitudinal relationships are observed for anxiety disorders, particularly in relation to three distinct indicators of activity levels - sports participation, general physical activity and sedentary behavior.
  
  
  METHODS
  Participants were from the Netherlands Study of Depression and Anxiety (NESDA; N = 2932, 18-65 years old; 57% current anxiety or depressive disorder, 21% remitted disorder, 22% healthy controls). At baseline, 2, 4, and 6 years, participants completed a diagnostic interview and self-report questionnaires assessing psychopathology symptom severity, physical activity indicators, and sociodemographic and health covariates.
  
  
  RESULTS
  Consistently across assessment waves, people with anxiety and/or depressive disorders had lower sports participation and general physical activity compared to healthy controls. Greater anxiety or depressive symptoms were associated with lower activity according to all three indicators. Over time, a diagnosis or greater symptom severity at one assessment was associated with poorer sports participation and general physical activity 2 years later. In the opposite direction, only low sports participation was associated with greater symptom severity and increased odds of disorder onset 2 years later. Stronger effects were observed for chronicity, with lower activity according to all indicators increasing the odds of disorder chronicity after 2 years.
  
  
  CONCLUSIONS
  Over time, there seems to a mutually reinforcing, bidirectional relationship between psychopathology and lower physical activity, particularly low sports participation. People with anxiety are as adversely affected as those with depression.
authors.affiliation: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors.forename: S A
authors.initials: SA
authors.lastname: Hiles
authors.affiliation: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Lamers
authors.affiliation: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors.forename: Y
authors.initials: Y
authors.lastname: Milaneschi
authors.affiliation: Department of Psychiatry and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors.forename: B W J H
authors.initials: BWJH
authors.lastname: Penninx
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000503:physiopathology*; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D015444:Exercise; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D057185:Sedentary Behavior; D055815:Young Adult
keywords: Anxiety; depression; exercise; longitudinal study; physical activity; prospective study; sedentary behavior; sport