Association between physical activity and comorbid anxiety/depression in 46 low- and middle-income countries

Ruimin Ma, Eugenia Romano, Davy Vancampfort, Joseph Firth, Brendon Stubbs, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Evidence on the association of low physical activity (PA) with depression or anxiety is well established. Yet, evidence on the association between PA and comorbid anxiety/depression remains scarce, especially in low- and middle-income countries (LMICs). Thus, this study explored this relationship among adults aged ≥18 years from 46 LMICs.

METHODS: Cross-sectional, community-based data were analyzed from the World Health Survey (WHS). Multivariable multinomial logistic regression analysis was conducted to examine the association between low PA and comorbid anxiety/depression with no anxiety or depression as the base category.

RESULTS: 237,023 participants [mean (SD) age = 38.4 (16.0) years; 50.8 % female] were included in the analysis. Low PA was significantly associated with depression alone (OR = 1.33; 95%CI = 1.12-1.57) and anxiety alone (OR = 1.37; 95%CI = 1.23-1.53), while the OR was highest among those with comorbid anxiety/depression (OR = 1.75; 95%CI = 1.52-2.01).

CONCLUSION: Low PA is associated with particularly increased odds for comorbid anxiety/depression. Increasing PA may have a beneficial effect on the prevention of comorbid anxiety/depression. However, future longitudinal research establishing the direction of this relationship is warranted.

Original languageEnglish
Pages (from-to)544-551
Number of pages8
JournalJournal of Affective Disorders
Early online date11 Oct 2022
Publication statusPublished - 1 Jan 2023


  • Humans
  • Adult
  • Female
  • Adolescent
  • Male
  • Depression/epidemiology
  • Developing Countries
  • Cross-Sectional Studies
  • Exercise
  • Comorbidity
  • Prevalence


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