Association between physical fitness index and psychological symptoms in left-behind children: a cross-sectional study from East China

Abstract

Abstract Objective: This study aimed to investigate psychological symptoms among left-behind children (LBC) and clarify the associations with their physical fitness index (PFI). Method: We tested 4705 LBC aged 13–18 years from three provinces in East China on seven physical fitness items using national student physical health standards. Participants’ PFI was calculated by standardizing the physical fitness item scores. Participants’ depression and anxiety symptoms were assessed with the Patient Health Questionnaire 9 and the General Anxiety Disorder 7, respectively. Chi-square tests were used to compare the detection rates of psychological symptoms by PFI levels. Associations between PFI levels and psychological symptoms were determined using binary logistic regression. Results: The detection rates of anxiety and depression symptoms among LBC were 35.98% and 33.99%, respectively. Univariate analysis showed PFI levels were statistically significantly related to psychological symptoms in boys and girls (anxiety: χ2=37.880 and 52.246, respectively; depression: χ2=29.885 and 68.735, respectively; P<0.05 for all). The multivariate analysis indicated different PFI levels were positively associated with psychological symptoms in both boys (low-level anxiety: odds ratio [OR]=3.898, 95% confidence interval [CI] 2.464–5.982; low-level depression: OR=3.923, 95%CI 2.473–6.223; mid-level anxiety: OR=1.747, 95%CI 1.194–2.555; mid-level depression: OR=1.926, 95%CI 1.298–2.858) and girls (low-level anxiety: OR=4.543, 95%CI 3.032–6.806; low-level depression: OR=6.476, 95%CI 4.096–10.239; mid-level anxiety: OR=3.436, 95%CI 2.437–4.845; mid-level depression: OR=5.001, 95%CI 3.345–7.479) (P<0.05 for all). Conclusicons: Low and middle PFI levels may be risk factors for psychological symptoms among LBC. Improving physical fitness may reduce psychological health problems in this population.