Depression and its relationship to physical activity, sedentary behaviour, and body mass index (BMI) in Malaysian adolescents: a cross-sectional study.

INTRODUCTION: Adolescence signifies a crucial developmental period characterized by heightened susceptibility to prevalent health issues, including obesity and mental health disorders. This research aims to examine the association between Body Mass Index (BMI), physical activity, sedentary behaviour, and depression among adolescents. METHODS: Data from the 2022 National Health and Morbidity Survey (NHMS): Adolescent Health Survey was analysed using a nationwide cross-sectional approach with a two-stage stratified random sampling method. The survey included a representative sample of secondary school students. Depression levels were evaluated using the Patient Health Questionnaire (PHQ-9), with a score of 10 or above indicating depression. Body Mass Index (BMI) was assessed using anthropometric measurement (weight and height) and interpreted using WHO 2007 Growth Reference Data for 5-19 years. A total of 33,523 school-attending adolescents participated in the survey, yielding a response rate of 89.4%. For the purpose of this study, however, analysis was limited to data from 33,407 respondents who fully completed all PHQ-9 questions. Descriptive and complex sample logistic regression analyses were performed using SPSS version 26.0. RESULTS: The prevalence of depression among Malaysian adolescents was 26.9%. Multiple logistic regression analysis indicated that female adolescents (AOR: 2.66, 95% CI: 2.46, 2.87) and those in higher age exhibited a higher likelihood of experiencing depression. Conversely, Chinese (AOR: 0.58, 95% CI: 0.48, 0.69) and Indian adolescents (AOR: 0.67, 95% CI: 0.54, 0.82) were less likely to experience depression. Depression was associated with increased sedentary behaviour (AOR: 2.01, 95% CI: 1.85, 2.18) and obesity (AOR: 1.12, 95% CI: 1.01, 1.23). CONCLUSION: The findings indicate that one in four Malaysian adolescent experiences depression, with significant risk factors including gender, age, high levels of sedentary behavior, and obesity. These findings emphasize the importance of public health strategies that address these critical factors and depression by encouraging active lifestyles, reducing obesity, and incorporating mental health interventions.