Transtornos mentais em escolares : associações com indicadores de atividade física, desempenho físico e contexto sociodemográfico

Abstract

Introduction: Mental disorders are among the leading causes of illness among children and adolescents. In this context, Brazil has the highest prevalence of depression in Latin America, and Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most frequent demands in child mental health services in the country. Evidence indicates that movement behaviors and sociodemographic components may be associated with these disorders. The present study aimed to analyze the role of sedentary behavior, physical activity, physical fitness, and sociodemographic components as potential factors associated with depressive symptoms, ADHD signs, and other mental disorders. Methods: A cross-sectional study was conducted and approved by the Research Ethics Committee of the University of Caxias do Sul under opinion No. 6,993,200. The study evaluated 125 students from the municipal education system of Garibaldi, Rio Grande do Sul, Brazil, aged between 8 and 11 years, during the second semester of 2024 and the first semester of 2025. Participants performed the physical performance tests of the Projeto Esporte Brasil (PROESP-Br) and completed two questionnaires: the Physical Activity Questionnaire for Children (PAQ-C), to assess physical activity level, and the Child Depression Inventory (CDI), to assess childhood depressive symptoms. The students were also assessed by their classroom teacher using the Swanson, Nolan, and Pelham Scale, version IV (SNAP-IV), an instrument designed to identify signs and symptoms of ADHD. The collected data were analyzed using IBM SPSS Statistics software (version 27) through the application of the t-test, chi-square test, Spearman's correlation, and logistic and linear regression analyses. In addition to the cross-sectional study, a systematic review of studies evaluating the association between physical activity and/or sedentary behavior and mental health outcomes in Brazilian students aged up to 19 years was conducted. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, and its protocol was previously registered in the Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420261284986. Results: The results of the cross-sectional study were divided into two articles entitled: Maternal educational level and physical fitness: impact on childhood depressive symptoms in schoolchildren from Southern Brazil; and The influence of physical fitness on symptoms related to Attention-Deficit/Hyperactivity Disorder in schoolchildren from Southern Brazil. The results showed that children of mothers with higher education had an 87.7% reduction in the odds of presenting clinically relevant depressive symptoms compared with those whose mothers had only completed elementary education. Regarding signs of attention deficit, children of mothers with elementary education obtained higher scores than those whose mothers had higher education. Additionally, participants in the risk zone on the medicine ball throw test had a 3.66-fold higher odds of expressing clinically significant depressive symptoms compared with those in the healthy zone. Regarding attention deficit, six of the seven physical fitness tests were associated with the outcome, with cardiorespiratory fitness standing out, as better performance was associated with reduced odds and lower scores for these signs. In the systematic review, the main outcomes analyzed were insomnia, social isolation, mental health, common mental disorders, and suicidal ideation. Overall, the findings indicated that physical activity may provide greater mental health benefits for adolescents when performed in groups, during Physical Education classes, or through team sports, whereas sedentary behavior, particularly screen time, was a risk factor. Conclusion: Child and adolescent mental health may be directly influenced by both the socio-family context and movement behaviors. In addition to promoting physical fitness, Physical Education teachers should be prepared to address students' emotional needs, with collective physical activity providing an ideal setting for identifying such needs. [resumo fornecido pelo autor]