Complete mental health status and associations with physical activity, screen time, and sleep in youth

Problem: Mental well-being can be conceptualized as two intersecting continua: mental illness (presence/absence of psychopathology) and mental health (flourishing/languishing). Together, mental illness and mental health combine to form an individual's complete mental health status (CMHS). The purpose of this study was to examine if CMHS is associated with adherence to the guidelines for moderate-to-vigorous physical activity (MVPA; 60 min), sleep (8-10 h) and recreational screen time (ST; <= 2 h) represented in the Canadian 24-h Movement Guidelines for Children and Youth ("Guidelines") in adolescents. Methods: This study reports cross-sectional student-level data from Year 6 (2017-18) of the COMPASS study. Canadian secondary school students (grades 9-12) completed questionnaires assessing their movement behaviours, flourishing/languishing (F/L), and high/low depressive symptoms (+DS/-DS). Students were classified into one of four CMHS groups: F/-DS, F/+DS, L/-DS, L/+DS. Generalized linear models were used to compare adherence to the guidelines between groups. Results: A total of 29,133 students (49.8% female, Mage = 15.3yrs) were included. For ST and sleep, youth classified as L/+DS were less likely to meet Guidelines than youth categorized as L/-DS, F/+DS, and F/-DS. For MVPA, youth categorized as L/+DS were less likely to meet Guidelines than youth categorized as F/-DS or F/ +DS. Individuals classified as L/-DS were less likely to meet the MVPA guidelines compared to L/+DS (ps < .0001). Conclusion: This is the first study examining relationships between CMHS and Guideline adherence. CMHS was associated with both ST and sleep. Youth who self-report flourishing were more likely to achieve MVPA guidelines irrespective of depressive symptoms. Such findings reinforce the need for research considering both mental health and mental illness when examining associations with movement behaviours in youth.