Depression and health behaviors in Brazilian adults – PNS 2013

Barros, Marilisa Berti de Azevedo; Lima, Margareth Guimarães; Azevedo, Renata Cruz Soares de; Medina, Lhais Barbosa de Paula; Lopes, Claudia de Souza; Menezes, Paulo Rossi; Malta, Deborah Carvalho

doi:10.1590/S1518-8787.2017051000084

Brasil

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Original Articles • Rev. Saúde Pública 51 (suppl 1) • 2017 • https://doi.org/10.1590/S1518-8787.2017051000084 linkcopy

Depression and health behaviors in Brazilian adults – PNS 2013

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To evaluate the prevalence of health-related behaviors according to presence and type of depression in Brazilian adults.

METHODS Based on a sample of 49,025 adults (18 to 59 years) from the National Survey on Health 2013 (PNS 2013), we estimated the prevalence of health-related behaviors (smoking; passive smoking; frequent or risky alcohol consumption; leisure time physical activity; time watching TV; and eating pattern indicators), according to the presence of depression (minor and major), evaluated by the Patient Health Questionnaire – 9 (PHQ-9), and the report of depressive mood (in up to seven days or more than seven days) over a two-week period. Prevalence ratios were estimated by Poisson regression.

RESULTS Evaluated by the PHQ-9 scale, 9.7% of the Brazilian adults had depression and 3.9% presented major depression. About 21.0% reported depressive mood and, in 34.9% of them, that feeling has been present for more than seven days. In individuals with major depression (PHQ-9), higher prevalence was found in almost all unhealthy behaviors analyzed, in particular, smoking (PR = 1.65), passive smoking (PR = 1.55), risk alcohol consumption (PR = 1.72), TV for ≥ 5 hours/day (PR = 2.13), consumption of fat meat (PR = 1.43) and soft drink (PR = 1.42). The prevalence ratios tended to be lower in those with minor depression. Similar results were observed in adults with depressive mood.

CONCLUSIONS This study detected relevant association between depression and health behaviors, in particular for smoking and physical activity. The associations found with the PHQ were similar to those observed with the application of a single question about depressive mood. Our results indicate the importance of assessing the presence of depression and the frequency and severity of symptoms when implementing actions for the promotion of healthy behaviors.

Depressive Disorder, epidemiology; Health Behavior; Health Knowledge, Attitudes, Practice; Health Surveys

Health behavior	No depression (1)^a n = 43,881	With minor depression (2) n = 3,107	With major depression (3) n = 2,037	Adjusted PR^b 95%CI

				(2/1)		(3/1)		(3/2)
Smoking
Current smoker	14.5	20.2	22.8	1.52	1.32–1.75	1.65	1.38–1.97	1.01	0.97–1.06
Stopped smoking	49.2	44.2	48.8	0.78	0.65–0.94	0.93	0.74–1.17	1.03	0.97–1.08
Passive smoker at home	10.3	15.8	16.7	1.48	1.22–1.79	1.55	1.25–1.95	1.00	0.95–1.06
Alcohol intake
Regular intake (≥ 1 time/month)	29.6	22.8	22.0	0.96	0.83–1.10	1.01	0.83–1.22	1.00	0.97–1.04
Intake ≥ 3 times/week	6.0	6.6	5.6	1.55	1.18–2.04	1.41	0.99–2.01	0.98	0.90–1.06
Risky intake among drinkers	35.5	35.4	43.0	1.17	0.95–1.44	1.72	1.34–2.21	1.07	1.02–1.13
Physical activity/sedentary lifestyle
Inactive or insufficiently active at leisure time	74.7	82.2	86.9	1.25	1.06–1.48	1.57	1.28–1.94	1.04	1.00–1.09
TV for ≥ 5 hours	11.6	18.9	24.5	1.58	1.36–1.84	2.13	1.79–2.5	1.06	1.02–1.10
Feeding
Uncooked vegetables consumption ≤ 5 times/week	54.1	55.1	60.3	1.08	0.95–1.22	1.30	1.12–1.50	1.04	1.00–1.07
Fruit consumption ≤ 5 times/week	61.6	61.3	61.2	1.06	0.94–1.19	1.02	0.88–1.19	1.00	0.97–1.03
Fatty meat consumption	38.8	40.9	43.8	1.26	1.12–1.41	1.43	1.23–1.66	1.03	0.99–1.06
No fish consumption in the week	45.5	53.4	53.7	1.32	1.18–1.48	1.32	1.14–1.53	1.00	0.99–1.03
Sweet food consumption ≥ 5 times in the week	22.1	29.3	26.8	1.17	1.02–1.33	1.20	1.01–1.42	0.99	0.95–1.03
Consumption of soft drink or artificial juice ≥ 5 times in the week	25.8	26.8	26.2	1.49	1.30–1.70	1.42	1.20–1.69	1.01	0.97–1.04

Health behavior	No report of depressive feeling (depressive mood) (1)^a n = 38,122	With report of depressive feeling in up to seven days in the two weeks prior (2) n = 6,987	With report of depressive feeling in more than seven days in the two weeks prior (3) n = 3,916	Adjusted PR^b 95%CI

				(2/1)		(3/1)		(3/2)
Smoking
Current smoker	14.2	16.3	23.0	1.20	1.09–1.33	1.67	1.48–1.88	1.06	1.03–1.09
Stopped smoking	48.7	51.6	44.9	1.05	0.92–1.20	0.82	0.70–0.97	0.96	0.92–0.99
Passive smoker at home	9.9	13.9	15.7	1.32	1.18–1.48	1.47	1.25–1.75	1.02	0.98–1.06
Alcohol intake
Regular intake (≥ 1 time/month)	30.0	26.5	22.4	1.09	1.00–1.96	1.00	0.88–1.14	0.99	0.96–1.02
Intake ≥ 3 times/week	6.1	5.8	5.5	1.24	1.05–1.46	1.32	1.04–1.68	1.01	0.96–1.06
Risky intake among drinkers	36.0	32.5	39.9	0.99	0.88–1.23	1.44	1.19–1.74	1.07	1.03–1.11
Physical activity/sedentary lifestyle
Inactive or insufficiently active at leisure time	74.3	79.0	83.3	1.08	0.98–1.19	1.20	1.03–1.40	1.02	0.99–1.05
TV for ≥ 5 hours/day	11.6	13.1	21.3	1.08	0.97–1.22	1.72	1.51–1.95	1.10	1.07–1.13
Feeding
Uncooked vegetables consumption ≤ 5 times/week	54.3	53.3	57.6	1.00	0.92–1.08	1.15	1.03–1.28	1.03	1.00–1.06
Fruit consumption ≤ 5 times/week	61.5	61.8	61.8	1.08	1.00–1.16	1.06	0.96–1.18	1.00	0.98–1.02
Fatty meat consumption	38.8	39.0	42.8	1.13	1.04–1.24	1.35	1.21–1.50	1.03	1.01–1.06
No fish consumption in the week	45.0	49.9	53.4	1.17	1.08–1.27	1.32	1.19–1.46	1.02	1.00–1.04
Sweet food consumption ≥ 5 times in the week	22.0	24.6	26.3	1.11	1.02–1.21	1.16	1.03–1.29	1.01	0.98–1.03
Consumption of soft drink or artificial juice ≥ 5 times in the week	25.8	26.2	25.8	1.16	1.06–1.26	1.36	1.21–1.52	1.03	1.00–1.06

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[TFN1] Statistically significant values are presented in bold.

[TFN2] ^a Reference category.

[TFN3] ^b Adjusted by age, sex, and education level.