Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T22:22:51.503Z Has data issue: false hasContentIssue false
  • English
  • Français

Cardiovascular fitness in late adolescent males and later risk of serious non-affective mental disorders: a prospective, population-based study

Published online by Cambridge University Press:  28 June 2017

J. Nyberg ,
M. Henriksson ,
M. A. I. Åberg ,
A. Rosengren ,
M. Söderberg ,
N. D. Åberg ,
H. G. Kuhn  and
M. Waern
J. Nyberg
Affiliation:
Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
M. Henriksson
Affiliation:
Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
M. A. I. Åberg
Affiliation:
Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
A. Rosengren
Affiliation:
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
M. Söderberg
Affiliation:
Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
N. D. Åberg
Affiliation:
Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
H. G. Kuhn*
Affiliation:
Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
M. Waern
Affiliation:
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
*
*Address for correspondence: Professor Georg Kuhn, Department of Neuroscience and Physiology, University of Gothenburg, Medicinaregatan 11, Box 436, Gothenburg SE-40530, Sweden. (Email: georg.kuhn@neuro.gu.se)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship.

Method

Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3–42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life.

Results

Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29–1.61], other psychotic disorders (HR 1.41, 95% CI 1.27–1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37–1.54). Relationships persisted in models that included illness in brothers.

Conclusions

Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.

Keywords

Cardiovascular fitnessepidemiologyneurotic disorderspsychotic disordersschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 3 , February 2018 , pp. 416 - 425
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aberg, MA, Pedersen, NL, Toren, K, Svartengren, M, Backstrand, B, Johnsson, T, Cooper-Kuhn, CM, Aberg, ND, Nilsson, M, Kuhn, HG (2009). Cardiovascular fitness is associated with cognition in young adulthood. Proceedings of the National Academy of Sciences of the United States of America 106, 20906–20911.CrossRefGoogle ScholarPubMed
Aberg, MA, Waern, M, Nyberg, J, Pedersen, NL, Bergh, Y, Aberg, ND, Nilsson, M, Kuhn, HG, Toren, K (2012). Cardiovascular fitness in males at age 18 and risk of serious depression in adulthood: Swedish prospective population-based study. British Journal of Psychiatry 201, 352–359.Google Scholar
Bhui, K, Fletcher, A (2000). Common mood and anxiety states: gender differences in the protective effect of physical activity. Social Psychiatry and Psychiatric Epidemiology 35, 28–35.CrossRefGoogle ScholarPubMed
Bouchard, C, Blair, SN, Katzmarzyk, PT (2015). Less Sitting, More Physical Activity, or Higher Fitness? Mayo Clinic Proceedings 90, 1533–1540.Google Scholar
Christie, BR, Eadie, BD, Kannangara, TS, Robillard, JM, Shin, J, Titterness, AK (2008). Exercising our brains: how physical activity impacts synaptic plasticity in the dentate gyrus. Neuromolecular Medicine 10, 47–58.Google Scholar
Dalman, C, Broms, J, Cullberg, J, Allebeck, P (2002). Young cases of schizophrenia identified in a national inpatient register – are the diagnoses valid? Social Psychiatry and Psychiatric Epidemiology 37, 527–531.CrossRefGoogle Scholar
David, AS, Malmberg, A, Brandt, L, Allebeck, P, Lewis, G (1997). IQ and risk for schizophrenia: a population-based cohort study. Psychological Medicine 27, 1311–1323.Google Scholar
De Moor, MH, Beem, AL, Stubbe, JH, Boomsma, DI, De Geus, EJ (2006). Regular exercise, anxiety, depression and personality: a population-based study. Preventive Medicine 42, 273–279.Google Scholar
DiLorenzo, TM, Bargman, EP, Stucky-Ropp, R, Brassington, GS, Frensch, PA, LaFontaine, T (1999). Long-term effects of aerobic exercise on psychological outcomes. Preventive Medicine 28, 75–85.Google Scholar
Firth, J, Stubbs, B, Rosenbaum, S, Vancampfort, D, Malchow, B, Schuch, F, Elliott, R, Nuechterlein, KH, Yung, AR (2017). Aerobic exercise improves cognitive functioning in people with schizophrenia: a systematic review and meta-analysis. Schizophrenia Bulletin 43, 546–556.Google Scholar
Fryers, T, Brugha, T (2013). Childhood determinants of adult psychiatric disorder. Clinical Practice and Epidemiology in Mental Health 9, 1–50.Google Scholar
Gariepy, G, Nitka, D, Schmitz, N (2010). The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. International Journal of Obesity 34, 407–419.CrossRefGoogle ScholarPubMed
Gerber, M, Lindwall, M, Lindegard, A, Borjesson, M, Jonsdottir, IH (2013). Cardiorespiratory fitness protects against stress-related symptoms of burnout and depression. Patient Education and Counseling 93, 146–152.CrossRefGoogle ScholarPubMed
Gerber, M, Puhse, U (2009). Review article: do exercise and fitness protect against stress-induced health complaints? A review of the literature. Scandinavian Journal of Public Health 37, 801–819.Google Scholar
Harvey, SB, Hotopf, M, Overland, S, Mykletun, A (2010). Physical activity and common mental disorders. British Journal of Psychiatry 197, 357–364.CrossRefGoogle ScholarPubMed
Hettema, JM, Neale, MC, Kendler, KS (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry 158, 1568–1578.CrossRefGoogle ScholarPubMed
Hillman, CH, Erickson, KI, Kramer, AF (2008). Be smart, exercise your heart: exercise effects on brain and cognition. Nature Reviews Neuroscience 9, 58–65.Google Scholar
Jonsdottir, IH, Rodjer, L, Hadzibajramovic, E, Borjesson, M, Ahlborg, G Jr. (2010). A prospective study of leisure-time physical activity and mental health in Swedish health care workers and social insurance officers. Preventive Medicine 51, 373–377.Google Scholar
Kodama, S, Saito, K, Tanaka, S, Maki, M, Yachi, Y, Asumi, M, Sugawara, A, Totsuka, K, Shimano, H, Ohashi, Y, Yamada, N, Sone, H (2009). Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. Journal of the American Medical Association 301, 2024–2035.Google Scholar
Ludvigsson, JF, Andersson, E, Ekbom, A, Feychting, M, Kim, JL, Reuterwall, C, Heurgren, M, Olausson, PO (2011). External review and validation of the Swedish national inpatient register. BioMed Central Public Health 11, 450.CrossRefGoogle ScholarPubMed
Motl, RW, Birnbaum, AS, Kubik, MY, Dishman, RK (2004). Naturally occurring changes in physical activity are inversely related to depressive symptoms during early adolescence. Psychosomatic Medicine 66, 336–342.Google ScholarPubMed
Moylan, S, Eyre, HA, Maes, M, Baune, BT, Jacka, FN, Berk, M (2013). Exercising the worry away: how inflammation, oxidative and nitrogen stress mediates the beneficial effect of physical activity on anxiety disorder symptoms and behaviours. Neuroscience & Biobehavioral Reviews 37, 573–584.Google Scholar
Muhsen, K, Lipsitz, J, Garty-Sandalon, N, Gross, R, Green, MS (2008). Correlates of generalized anxiety disorder: independent of co-morbidity with depression: findings from the first Israeli National Health Interview Survey (2003–2004). Social Psychiatry and Psychiatric Epidemiology 43, 898–904.Google Scholar
Niemi, LT, Suvisaari, JM, Tuulio-Henriksson, A, Lonnqvist, JK (2003). Childhood developmental abnormalities in schizophrenia: evidence from high-risk studies. Schizophrenia Research 60, 239–258.Google Scholar
Nordesjö, LO, Schéle, R (1974). Validity of an ergometer cycle test and measures of isometric muscle strength when prediction some aspects of military performance. Swedish Journal of Defence Medicine 10, 11–23.Google Scholar
Okkenhaug, A, Tanem, T, Johansen, A, Romild, UK, Nordahl, HM, Gjervan, B (2016). Physical activity in adolescents who later developed schizophrenia: a prospective case-control study from the Young-HUNT. Nordic Journal of Psychiatry 70, 111–115.CrossRefGoogle ScholarPubMed
Ortega, FB, Ruiz, JR, Castillo, MJ, Sjostrom, M (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity 32, 1–11.Google Scholar
Pasco, JA, Williams, LJ, Jacka, FN, Henry, MJ, Coulson, CE, Brennan, SL, Leslie, E, Nicholson, GC, Kotowicz, MA, Berk, M (2011). Habitual physical activity and the risk for depressive and anxiety disorders among older men and women. International Psychogeriatrics 23, 292–298.CrossRefGoogle ScholarPubMed
Piepoli, MF, Hoes, AW, Agewall, S, Albus, C, Brotons, C, Catapano, AL, Cooney, MT, Corra, U, Cosyns, B, Deaton, C, Graham, I, Hall, MS, Hobbs, FD, Lochen, ML, Lollgen, H, Marques-Vidal, P, Perk, J, Prescott, E, Redon, J, Richter, DJ, Sattar, N, Smulders, Y, Tiberi, M, van der Worp, HB, van Dis, I, Verschuren, WM (2016). 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal 37, 2315–2381.Google Scholar
Rosenbaum, S, Tiedemann, A, Sherrington, C, Curtis, J, Ward, PB (2014). Physical activity interventions for people with mental illness: a systematic review and meta-analysis. Journal of Clinical Psychiatry 75, 964–974.Google Scholar
Sanchez-Villegas, A, Ara, I, Guillen-Grima, F, Bes-Rastrollo, M, Varo-Cenarruzabeitia, JJ, Martinez-Gonzalez, MA (2008). Physical activity, sedentary index, and mental disorders in the SUN cohort study. Medicine and Science in Sports and Exercise 40, 827–834.CrossRefGoogle ScholarPubMed
Schuch, FB, Vancampfort, D, Sui, X, Rosenbaum, S, Firth, J, Richards, J, Ward, PB, Stubbs, B (2016). Are lower levels of cardiorespiratory fitness associated with incident depression? A systematic review of prospective cohort studies. Preventive Medicine 93, 159–165.Google Scholar
Strohle, A, Hofler, M, Pfister, H, Muller, AG, Hoyer, J, Wittchen, HU, Lieb, R (2007). Physical activity and prevalence and incidence of mental disorders in adolescents and young adults. Psychological Medicine 37, 1657–1666.CrossRefGoogle ScholarPubMed
Ten Have, M, de Graaf, R, Monshouwer, K (2011). Physical exercise in adults and mental health status findings from the Netherlands mental health survey and incidence study (NEMESIS). Journal of Psychosomatic Research 71, 342–348.Google Scholar
Tsatsoulis, A, Fountoulakis, S (2006). The protective role of exercise on stress system dysregulation and comorbidities. Annals of the New York Academy of Sciences 1083, 196–213.CrossRefGoogle ScholarPubMed
Vancampfort, D, Rosenbaum, S, Probst, M, Soundy, A, Mitchell, AJ, De Hert, M, Stubbs, B (2015). Promotion of cardiorespiratory fitness in schizophrenia: a clinical overview and meta-analysis. Acta Psychiatrica Scandinavica 132, 131–143.CrossRefGoogle ScholarPubMed
Vancampfort, D, Rosenbaum, S, Schuch, F, Ward, PB, Richards, J, Mugisha, J, Probst, M, Stubbs, B (2017). Cardiorespiratory fitness in severe mental illness: a systematic review and meta-analysis. Sports Medicine 47, 343–352.Google Scholar
Weinstein, AM, Voss, MW, Prakash, RS, Chaddock, L, Szabo, A, White, SM, Wojcicki, TR, Mailey, E, McAuley, E, Kramer, AF, Erickson, KI (2012). The association between aerobic fitness and executive function is mediated by prefrontal cortex volume. Brain behavior and Immunity 26, 811–819.CrossRefGoogle ScholarPubMed
WHO (1967). World Health Organization: International Statistical Classification of Diseases and Related Health Problems (ICD-8) . WHO Press: Geneva.Google Scholar
WHO (1978). World Health Organization: International Statistical Classification of Diseases and Related Health Problems (ICD-9) . WHO Press: Geneva.Google Scholar
WHO (1992). World Health Organization: The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO Press: Geneva.Google Scholar
Wittchen, HU, Jacobi, F, Rehm, J, Gustavsson, A, Svensson, M, Jonsson, B, Olesen, J, Allgulander, C, Alonso, J, Faravelli, C, Fratiglioni, L, Jennum, P, Lieb, R, Maercker, A, van Os, J, Preisig, M, Salvador-Carulla, L, Simon, R, Steinhausen, HC (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology 21, 655–679.Google Scholar
Zschucke, E, Renneberg, B, Dimeo, F, Wustenberg, T, Strohle, A (2015). The stress-buffering effect of acute exercise: evidence for HPA axis negative feedback. Psychoneuroendocrinology 51, 414–425.Google Scholar