Associations of Domain and Pattern of Sedentary Behaviors with Symptoms of Mental Disorders in Saudi Adults: 'The Sedentary Behavior Paradox'

Emerging evidence suggests the existence of 'paradoxical' relationships between domain-specific sedentary behavior (SB) and health outcomes. This study assessed the associations of total and domain-specific SB, by pattern, with symptoms of mental disorders in Saudi adults. Participants (n = 554) completed a web-based survey between January 18th, 2023 and February 5th, 2023. Total SB was measured by using the Sedentary Behavior Questionnaire. Total SB was then partitioned into leisure, occupational, and commuting SB during weekdays and on weekend days. Symptoms of mental disorders including symptoms of depression, anxiety, and stress were evaluated by using the DASS-21 questionnaire. Adjusted linear regressions estimated associations of SB with these symptoms of mental disorders. Mann-Whitney tests compared these symptoms between Saudi adults who accumulated excessive total SB (>= 8 hours/day) and those who did not. The results showed that higher total and leisure SB was associated with unfavorable symptoms of depression, anxiety, and stress (p < 0.05 for all). Paradoxically, greater occupational SB on weekend days and commuting SB in weekdays favorably associated with depressive symptoms (p < 0.05 for all). Saudi adults who accumulated excessive total SB had worse symptoms of mental disorders (p < 0.05 for all). In summary, these findings provide evidence for the existence of the 'Paradoxical Sedentary Behavior' regarding depression. All SB is not created equal. Interventions that aim at improving mental health should target not only excessive total SB, but also total and domain-specific SB during the week and in weekdays and on weekend days while using individualized strategies.