Association between Lifestyle Behaviours and Mental Health of Adolescents: Evidence from the Canadian HBSC Surveys, 2002-2014

Physical activity (PA) and screen time (ST) are associated with mental health in adolescents, though little is known about their inter-relationships. This study examined the associations of PA and ST with psychosomatic complaints in adolescents. Data from four cycles of the Canadian Health Behaviour in School-aged Children (HBSC) surveys, collected between 2002 and 2014, were analysed. Eight psychosomatic health complaints were assessed and dichotomised as frequent (>= 2 complaints/week) vs. infrequent. PA was assessed by number of days/week participants were physically active for >= 60 min. Discretionary ST was assessed by adding three screen uses: television, electronic games, and computer. Of the 37,829 adolescents (age 13.74 (SD 1.51) years; 52% girls), 25% boys and 39% girls reported frequent psychosomatic complaints. Multilevel logistic analyses showed that ST levels were positively associated while PA levels were negatively associated with reporting frequent psychosomatic complaints in a dose-dependent manner. Compared with ST <= 2 hrs/d, ST >= 4 hrs/d in girls and ST >= 6 hrs/d in boys showed higher odds of reporting psychosomatic complaints. Participating in PA >= 60 min every day compared to no PA showed lower odds of reporting psychosomatic complaints by 44% in girls and 57% in boys. Prospective research is needed to understand the causal pathway of these dose-dependent relationships.