Associações entre atividade física de lazer, características de trabalho e depressão em adultos

Abstract

The main objective of this thesis was to analyze the association between leisure-time physical activity, work characteristics, and depression in the Brazilian adult population. Two manuscripts are included in this thesis. The first aimed to investigate whether there is an association between physical activity, measured by self-report, and depression in adults according to the level of sedentary behavior, based on screen time. The study used data from the 2019 National Health Survey. This first approach used a representative sample of Brazilian adults, composed of 86,509 individuals, with a mean age of 47.4 ± 17.1. The outcome assessed in both manuscripts was depression, using the PHQ-9 instrument (validated questionnaire composed of 9 items) and adopting the cutoff point of ≥ 10. The statistical analysis used to assess the association between leisure-time physical activity and depression, controlled for confounders, was logistic regression, through which the respective odds ratios with confidence intervals (95% CI) were calculated, stratified by levels of screen exposure greater than 3 hours per day during leisure time. The survey package of the R software was used to consider the PNS sampling plan and the sample weight in both manuscripts. The results of the first study indicated that the practice of leisure-time physical activity higher (OR = 0.66 [CI = 0.60-0.72]) or lower (OR = 0.84 [CI = 0.73-0.97]) than 150 minutes per week is associated with reduced odds of depression, when compared with physically inactive individuals. In the second manuscript, the association between work characteristics and depression was investigated according to sex and leisure-time physical activity using data from the 2019 PNS. The sample used in the present study consisted of 51,579 working individuals (defined through self-report through interviews), with a mean age of 42.3 ± 13.1. The statistical analysis used to assess the association between work characteristics and depression was multiple logistic regression. It is important to emphasize that the analysis was stratified by sex and leisure-time physical activity (LTPA). Odds ratios with respective confidence intervals (95% CI) were calculated. The results showed that jobs with high physical load (OR = 1.27 [CI = 1.10-1.47]) and night shifts (OR = 1.42 [CI = 1.20-1.68]) are associated with a greater chance of depression, compared to those with low physical load and who worked day shifts. A 24-hour workday, among men with a weekly frequency of leisure-time physical activity greater than 2 sessions per week (OR = 0.14 [CI = 0.02-0.78]), reduces the chances of depression when compared to workers who did not perform this type of workday. The findings of this thesis demonstrate the importance of leisure-time physical activity as a behavior that can contribute to reducing the chances of depression, even among individuals with high levels of sedentary behavior. It also shows that less favorable work characteristics increase the chances of depression in both sexes