Research paperRecurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood
Introduction
Cardiorespiratory fitness (CRF) is the ability of the circulatory, respiratory, and muscular systems to supply oxygen during sustained physical activity (Lee et al., 2010). CRF in late adolescence (Crump et al., 2016), young adulthood (Carnethon et al., 2003), and middle age (Kennedy et al., 2018) have been shown to be strong predictors of future health. CRF is partially determined by genetic factors (Bouchard et al., 2011). During adulthood, physical activity, obesity, underweight, smoking, and socioeconomic status (SES) have been associated with CRF (Lakoski et al., 2011; Nikolakaros et al., 2017; Ombrellaro et al., 2018).
Childhood psychopathology can have profound effects on adult health (Duarte et al., 2010; Goodwin et al., 2009; Sourander et al., 2009). Childhood depression may recur (Rao and Chen, 2009), and it may coexist with conduct disorder (Ingoldsby et al., 2006).
Five cross-sectional studies have reported that childhood psychopathology, mostly depressive symptoms, were associated with lower CRF during childhood and adolescence (Esmaeilzadeh, 2015; LaVigne et al., 2016; Rieck et al., 2013; Shomaker et al., 2012; Yeatts et al., 2017). Depressive symptoms in obese adolescents were associated with lower CRF (Shomaker et al., 2012). Another study of adolescents aged 10-14 found that higher CRF was associated with less depressive symptoms in both sexes and with less internalizing symptoms in males (LaVigne et al., 2016). Esmaeilzadeh, 2015 showed that CRF was associated with depressive symptoms in subjects aged 7-11 years. Rieck et al., 2013 reported that high CRF was associated with a lower level of depression in adolescents aged 11-15. Yeatts et al., 2017 showed that high CRF was associated with less depressive symptoms in adolescents with high levels of neuroticism. One longitudinal study found that high baseline CRF prevented the onset of new depressive symptoms in adolescents over a one-year period (Ruggero et al., 2015). Another longitudinal study of adolescents found that CRF decreased with increasing levels of depressive symptoms over a period of four years (Olive et al., 2016). To our knowledge, there has been only one previous study that has examined childhood determinants of CRF in adults. That study found no association between parental SES during childhood and CRF during military service (Stea et al., 2009).
The existing literature suggests that there is an association between depression and CRF during adolescence, but there are no existing studies on the effects of childhood and adolescent psychopathology on adult CRF. Such an association is plausible for two reasons. Firstly, childhood psychopathology has been associated with the development of somatic (Duarte et al., 2010; Goodwin et al., 2009) and psychiatric (Sourander et al., 2009) morbidity in adulthood. Secondly, childhood depression has been shown to have a bidirectional association with physical activity (Stavrakakis et al., 2012), and physical activity has been shown to be a strong predictor of CRF (Lakoski et al., 2011). Given the salient effects of CRF on mortality and morbidity, understanding any associations between CRF and factors during childhood and adolescence is of major public health importance.
Our population-based study of young Finnish male military conscripts has previously shown that smoking in late adolescence and body composition in young adulthood were associated with CRF in young adulthood (Nikolakaros et al., 2017). The present study extended that assessment to examine any associations between CRF in early adulthood and psychopathology, namely depressiveness, neuroticism, and conduct problems and SES in childhood and depressive symptoms in late adolescence. We measured CRF with Cooper's 12-minute run (12MR) test (Cooper, 1968), a widely used objective measure of CRF (Hamari et al., 2010; Nikolakaros et al., 2017). We took into account the effects of smoking in late adolescence and body composition at the time of the CRF assessment by including them as covariates in the models. Our first research hypothesis was that childhood psychopathology and SES would predict adult CRF. Our second research hypothesis was that the recurrence of childhood depression in late adolescence would be associated with a more profound effect.
Section snippets
Methods
This investigation was a part of our longitudinal population-based ‘‘From a Boy to a Man’’ study (Sourander et al., 2004), which belongs to the Finnish Psychiatric Birth Cohort Consortium (PSYCOHORTS, www.psycohorts.fi). The study is focusing on a large cohort of Finnish children and assessing adult health-related outcomes in relation to child psychopathology. The initial cohort comprised 2964 subjects, a representative sample of Finnish males born in 1981. The present study gathered
Childhood predictors
In the single predictor models of childhood factors, low parental education, family structure, childhood depressive symptoms, childhood conduct problems, and childhood hyperactivity predicted a lower 12MR score (Table 1, Models A). Low parental education, childhood depressive symptoms, and childhood conduct problems remained significant in the multiple predictor analysis (Table 1, Model B). A single predictor model was also used with childhood depressiveness as a categorical variable: compared
Discussion
In this population-based study of young men assessed as healthy for military service, we have shown, for the first time, that childhood psychopathology and SES predict adult CRF. Depressive and conduct symptoms at the age of eight and depressive symptoms in late adolescence predicted lower CRF in young adulthood. The effect of childhood depressive symptoms was much stronger in subjects who were also depressed in late adolescence. In this group, the effect of childhood depressive symptoms was
Conclusions
This study has shown, for the first time, that psychopathology and lower SES during childhood predict lower CRF in young adulthood. Depressive symptoms that occur in both childhood and late adolescence may confer a particularly increased and independent risk of having low CRF as a young adult. Given the salient contribution of CRF to health, our results highlight the importance of treating child and adolescent psychopathology to avoid long-term adverse effects on CRF and physical and
Contributors
GN conceptualized and designed the study, reviewed the literature, designed and carried out statistical analyses, and drafted the initial manuscript. TV designed and supervised statistical analyses. LS designed and carried out statistical analyses. AS conceptualized and designed the study. All authors reviewed and revised the manuscript and approved the final manuscript as submitted.
Role of the funding source
This research was funded by the Academy of Finland Flagship Program (decision number: 320162), the Strategic Research Council at the Academy of Finland (decision number: 303581) and the Academy of Finland Health from Cohorts and Biobanks Program (decision number: 308552).
Declaration of Competing Interest
All authors declare that they have no conflicts of interest.
Acknowledgements
None.
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