運動軌跡與憂鬱情緒軌跡的性別差異：13-22歲學生的長期追蹤研究

Sex differences between exercise trajectories and depressive mood trajectories in students aged 13-22 years

目標：青少年心理健康問題日益嚴重，過去研究顯示運動與憂鬱為負向關係，但缺乏長期追蹤研究。本研究使用雙軌跡模型，分析13至22歲間不同性別之運動軌跡與憂鬱情緒軌跡的長期發展關係。方法：採用「兒童與青少年行為之長期發展研究」（CABLE）資料，分析13-22歲追蹤樣本，共1,969人。透過群體基礎軌跡模型，將男性與女性的運動軌跡與憂鬱情緒軌跡進行分組，再進行多元羅吉斯迴歸分析。結果：運動軌跡在男女均分為三組：持續高運動、運動下降、持續低運動；憂鬱情緒軌跡，男性有四組：持續低憂鬱、憂鬱偏低、中等憂鬱、持續高憂鬱；女性有五組：持續低憂鬱、憂鬱偏低、中憂鬱緩升、高憂鬱下降、持續高憂鬱。其軌跡分布具性別差異，男性在「持續高運動組」最多（45.69%），女性卻在「持續低運動組」最多（50.80%），且女性運動軌跡，從國中便持續下降，男性則是高中才開始下降；女性相較男性有較高比例為「持續高憂鬱」（9.35% vs 14.71%），和較低比例為「持續低憂鬱組」（15.58% vs. 5.07%）。不論男女，與持續高運動者相比，持續低運動者更可能有高憂鬱情緒軌跡。結論：無論男女，運動軌跡和憂鬱情緒軌跡呈現負向關係。部分國中階段高憂鬱情緒之學生，之後會發展為持續高憂鬱。建議從國中開始監測學生憂鬱情緒，並對高憂鬱情緒者適時介入；維持並提升學生的運動頻率，規劃具性別敏感的運動政策，尤其鼓勵女性運動，以促進心理健康。（台灣衛誌2025；44（3）：269-284）

Objectives: Adolescent mental health is generally declining. Although research has revealed a negative correlation between exercise and depression, long-term studies on this topic remain limited. In this study, we used a dual-trajectory model to investigate the long-term developmental relationship between exercise trajectories and depressive mood trajectories in students (age: 13- 22 years) stratified by sex. Methods: Relevant data were obtained from the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study. Our cohort comprised 1,969 individuals aged 13-22 years. Exercise trajectories and depressive mood trajectories were stratified by sex through group-based trajectory modeling; this was followed by multinomial logistic regression. Results: Exercise trajectories were classified as follows for both male and female students: consistently high, declining, and consistently low. Depressive mood trajectories were categorized into four types for male students-- consistently low, mild, moderate, and consistently high-- and five types for female students-- consistently low, mild, moderate with a gradual increase, high with a decline, and consistently high. These trajectories differed by sex. Most male students engaged in consistently high levels of exercise (45.69%), whereas most female students engaged in consistently low levels of exercise (50.80%). Both sexes exhibited a general decline in exercise trajectories, with this beginning in junior high school for female students and in high school for male students. However, no significant association was observed between declining exercise trajectories and high depressive mood risks. Notably, the percentage of‘consistently high depression’group was higher among female students than among male students (14.71% vs. 9.35%), whereas that of‘constantly low depression’group was lower among female students than among male students (5.07% vs. 15.58%). Regardless of sex, students in the‘consistently low exercise’group were more likely to be consistently high depressive mood trajectory. Conclusions: Exercise trajectories and depressive mood trajectories have negative relationship in both male and female individuals. Those with high depressive mood levels in junior high school later exhibited consistently high depression levels. Thus, we recommend monitoring depressive mood from junior high school and implementing timely interventions. Enhancing exercise frequency and developing sex-sensitive policies, particularly those aimed at increasing female participation, may support adolescent mental health. (Taiwan J Public Health. 2025;44(3):269-284)