Community activities could help tackle depression in the developing world

Atlas Award-winning study in Journal of Affective Disorders shows link between depression and sedentary behavior is strongest in cities

Getting people involved in community activities like playing games and social events could be a low-cost way to tackle depression in the developing world, according to a study in the Journal of Affective Disorders.

Sedentary behavior is on the rise around the world and has been linked to a whole host of problems, including heart disease and stroke, to diabetes and premature death. It's now clear that being inactive is also linked to depression, which is a growing issue in low- and middle-income countries, where sedentary behavior is on the rise.

The lead author of the study, Dr. Davy Vancampfort, from KU Leuven in Belgium, says the new study highlights a need to take a new approach to mental and physical health in the developing world. "I think that in the future if we want more evidence-based healthcare in low-income countries, we need to bring these two different aspects of medicine together in a holistic health care model, which is currently absent in low-income countries," added Dr. Vancampfort.

Dr. Vancampfort and his international team of colleagues around the world show that sedentary behavior in individuals with depression is linked to lower levels of social cohesion, due to a low level of involvement in community and social activities. Their work has been selected by an international scientific committee to be given the Atlas award.

In a previous study, researchers looked at the impact of sedentary behavior on depression. They split participants into two groups: one group had to continue with their normal behavior; while the other group were asked to be sedentary for a period of one week. In the group asked to be sedentary, the level of depression increased significantly; when members of the second group changed back to their normal active behavior, depression rates dropped immediately.

This led Dr. Vancampfort to the idea that addressing sedentary behavior would be an effective way to tackle depression. Using data from the World Health Organization (WHO), the team studied 2,375 people with depression in six low- and middle-income countries. More than 11 percent of people were highly sedentary, meaning they were inactive for at least eight hours a day.

Notably, one factor strongly associated was a lack of involvement in community and social activities. There was also a strong link between depression and sedentary behavior in more urban settings, and this could be an increasing problem. In low-income countries, people are moving to cities, where they can afford a more sedentary lifestyle: they have more sedentary jobs and they can afford motorized transport. Identifying the link between depression, sedentary behavior and community activity in the city provides a solution.

"We're trying to invite people to join social activity programs in a non-stigmatized environment," said Dr. Vancampfort. "I think one step is having more community activities in centers within big cities. There should be physical activities, sitting together, culture-sensitive activities, playing cards, playing games. I think that's the way forward."

The next step for the research is to carry out longitudinal studies to determine whether sedentary behavior is causing depression or vice-versa. Ultimately, Dr. Vancampfort's aim is to promote a more holistic approach to healthcare in low- and middle-income countries, due to the strong link between mental and physical health.