key: cord-276591-aft3agxx
authors: Mittal, Vijay A.; Firth, Joseph; Kimhy, David
title: Combating the Dangers of Sedentary Activity on Child and Adolescent Mental Health During the Time of COVID-19
date: 2020-08-26
journal: J Am Acad Child Adolesc Psychiatry
DOI: 10.1016/j.jaac.2020.08.003
sha: 
doc_id: 276591
cord_uid: aft3agxx

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While the impact of the coronavirus disease 2019 (COVID-19) pandemic, subsequent quarantine, and social distancing on physical activity has been covered extensively, there has been limited focus on the resulting sedentary behaviour 1 on existing and emerging psychopathology. This is particularly disconcerting regarding children and adolescents, who rely on the ability to play to meet developmental milestones and require more exercise than adults. Youth populations have been significantly disrupted by school closures and home confinement and are in developmental periods that overlap with the emergence of serious mental illness. Therefore, it is important to consider the mental health consequences for youth, and also explore ways to combat sedentary activity for this vulnerable population.

Participation in individual and group exercise has been found to be a robust pro-health activity, both in terms of building social support structures and resiliency factors, as well as in engaging mechanisms driving the onset and persistence of serious mental illness. 2 There is now a large body of literature showing that physical inactivity increases the risk of mental illness. For example, while the relationships between physical activity and mental health have potential for reverse causality, well-powered mendelian randomization studies (which can determine causal relations), using objectively-assessed physical activity, have convincingly demonstrated that high levels of physical inactivity exert a casual effect on increased depression risk. 3 Alongside this, longitudinal data supported the protective effect of physical activity on depression and anxiety, 4 which are highly ubiquitous in childhood and adolescence, with benefits more pronounced in youth than adult samples. Likewise, sedentary behaviour has been found to correlate with risk markers in adolescents at clinical high-risk for psychosis. 5 The current reality of widespread COVID-19 infections in many countries pose a substantial challenge to remediating this state, especially with concerns about a looming J o u r n a l P r e -p r o o f additional waves. However, potential solutions do exist -these can be seen in terms of public space, school, and home-based strategies. Public space options are numerous, though some of the more promising strategies would require cooperation from government and adaptive public policy. For example, at the neighbourhood level local leaders might work to allow staggered and monitored playground access with hand sanitizer availability. Streets might be closed so that children and teens can play in a social distanced fashion in their community.

With close cooperation, these strategies could be easily adapted to meet the constraints and needs of lockdown/stay-at-home orders versus periods of social distancing.

Where outdoor school infrastructure is available, teacher-or trainer-led group physical activities can be conducted safely, as individual physical distancing can be 

Impact of COVID-19 pandemic on children and adolescents' lifestyle behavior larger than expected

Effects of exercise on anxiety and depression disorders: review of meta-analyses and neurobiological mechanisms

An exposure-wide and Mendelian randomization approach to identifying modifiable factors for the prevention of depression

Physical activity and mental health in children and adolescents: a review of reviews

Physical activity level and medial temporal health in youth at ultra high-risk for psychosis

Can active video games improve physical activity in adolescents? A review of RCT

All statements expressed in this column are those of the authors and do not reflect the opinions of the Journal of the American Academy of Child and Adolescent Psychiatry. See the Instructions for Authors for information about the preparation and submission of Letters to the Editor

ORCID Vijay A. Mittal, PhD: https://orcid.org/0000-0001-9017-5119 Joseph Firth, PhD: https://orcid.org/0000-0002-0618-2752 David Kimhy, PhD: https://orcid.org/0000-0001-7735-9378All authors contributed to the conceptual planning, drafting, and revision of the manuscript. All authors give final approval on the version to be published and agree to be accountable for all aspects of the work.