Perceived Stress and Domain-Specific Physical Activity in Relation to Anxiety and Somatic Symptom Burden Among Romanian Adults: A Cross-Sectional Online Survey
Aug 2026· Medicina· Vol 62· 0 citations· 22 references
Medicine
TL;DR
Perceived stress showed the strongest association with both anxiety and somatic symptom burden, and the use of a single total activity score concealed a more specific inverse association between vigorous leisure-time activity and somatic symptoms.
Abstract
Background and Objectives: Physical activity may relate to mental health differently depending on whether it is performed at work, for transport, or during leisure. Evidence regarding this distinction in Romanian community samples remains limited, and it is unclear whether these associations persist after accounting for perceived stress. We examined domain-specific physical activity, sedentary time and perceived stress in relation to anxiety and somatic symptom burden. Materials and Methods: This cross-sectional online survey included 307 Romanian adults aged 18–65 years. Physical activity was measured with the Global Physical Activity Questionnaire, perceived stress with the 14-item Perceived Stress Scale, anxiety with the Beck Anxiety Inventory, and somatic symptoms with the Patient Health Questionnaire-15. Spearman correlations were adjusted for multiple testing with the Benjamini–Hochberg false-discovery-rate procedure. Multivariable linear models used HC3 robust standard errors and included sex, age group, education, body mass index and religious affiliation as covariates. Scores for each physical activity domain were log(1 + x)-transformed and standardized. Sensitivity analyses considered participation versus non-participation, symptom severity categories, total activity and exclusion of an extreme activity value. Results: Median scores were 24 for perceived stress, 10 for anxiety and 7 for somatic symptoms. Perceived stress correlated with both anxiety (rho = 0.486) and somatic symptoms (rho = 0.428; both false-discovery-rate-adjusted p < 0.001). Vigorous leisure-time activity was inversely correlated with somatic symptoms (rho = −0.205; adjusted p = 0.002), whereas total physical activity was not associated with either outcome. In the fully adjusted models, a one-standard-deviation-higher PSS-14 score was associated with 5.57 more BAI points (95% CI 4.50–6.63) and 2.12 more PHQ-15 points (95% CI 1.62–2.63). Vigorous leisure-time activity remained associated with a lower PHQ-15 score (−0.84 points per standard deviation; 95% CI −1.35 to −0.32), but its association with BAI was no longer statistically significant after adjustment for perceived stress. Conclusions: Perceived stress showed the strongest association with both anxiety and somatic symptom burden. The use of a single total activity score concealed a more specific inverse association between vigorous leisure-time activity and somatic symptoms. Longitudinal studies using more representative sampling, objective measures of activity and broader confounder assessment are needed to clarify directionality and determine the potential relevance of vigorous leisure-time activity to somatic symptom burden.
In this online convenience sample of adults aged ≥50 years, sleep quality, anxiety symptoms, and total physical activity showed consistent cross-sectional associations and require confirmation in representative longitudinal studies.
Hammad S. Alhasan, M. Alshehri· Journal of Clinical Medicine· 0 citations
Physical activity did not show significant associations with psychological symptoms or sleep quality, and higher depression and stress scores predicted poorer sleep quality.
Musculoskeletal disorders (MSDs) are a leading cause of work-related disability and absenteeism. Despite their high prevalence among office workers, including university employees, little research has examined the association between MSDs, physical activity (PA), and stress in this population. This study investigates the prevalence of MSDs and their associations with PA levels and perceived stress among university employees. A cross-sectional survey was conducted among employees of the University of Turin and the Politecnico di Torino. Participants completed validated questionnaires assessing sociodemographic and occupational characteristics, MSDs (Nordic Musculoskeletal Questionnaire), PA (Global Physical Activity Questionnaire), and stress (Perceived Stress Scale). Negative binomial regression models estimated prevalence ratios (PRs) and 95% confidence intervals (CIs). Among 446 participants, 85.2% reported at least one MSD in the past year, most commonly affecting the neck (57.9%), lower back (47.8%), and shoulders (39.7%). No associations were found between PA and MSDs, though a trend was observed for hip/thigh disorders in participants engaging in vigorous PA (PR = 1.79, 95%CI 0.84–3.79). There was an indication of a higher occurrence of MSDs with prolonged sedentary behavior (≥ 10 h/day), though statistical significance was not reached. In contrast, perceived stress was associated with upper back disorders (moderate stress: PR = 2.34, 95%CI 1.17–4.69; high stress: PR = 3.06, 95%CI 1.27–7.34). University employees have a high prevalence of MSDs, with stress as a significant risk factor. Further research is needed to clarify these associations and guide workplace interventions.
Martina Ballesio, Beatrice Occhetto, M. Trucco et al.· Sport Sciences for Health· 0 citations
Abstract: This cross-sectional study identified mental health profiles among Brazilian adolescents and examined their associations with domain-specific physical activity (leisure time, school, and active commuting) and television (TV) viewing time. Data were obtained from 144,046 adolescents in the 2019 Brazilian National Survey of School Health (PeNSE, acronym in Portuguese). Self-reported indicators included the frequency of five emotional states, weekly minutes of physical activity in leisure time, physical education, and commuting, and daily TV hours. Latent class analysis classified adolescents based on their mental health profiles, and multinomial logistic regression estimated associations between physical activity domains and TV viewing time with mental health classes, adjusting for covariates. Six mental health profiles were identified: (1) school-related concern; (2) anxious and stressed; (3) subthreshold internalizing; (4) anxious, sad, and angry; (5) low symptom; (6) severe internalizing. Adolescents who engaged in physical activity in their leisure time and at school were more likely to belong to the low symptom class, while those who engaged in physical activity during commuting were more likely to be in class 6 (severe internalizing). Adolescents who watched two to four hours of TV per day were more likely to belong to class 1 (school-related concern), class 4 (anxious, sad, and angry), and class 5 (low symptom), whereas those who watched TV more than four hours/day were less likely to belong to class 3 (subthreshold internalizing) and class 6 (severe internalizing). These findings underscore that both the context and quantity of physical activity and TV time are differentially related to adolescent mental health profiles, implying the need for targeted surveillance and interventions.
Gillianne Crystina dos Anjos Cardoso, Rafael Martins da Costa, B. Costa et al.· Cadernos de Saúde Pública· 0 citations
Fatigue is a frequent problem that disrupts academic and social functioning in young adults. High levels of depression, anxiety, and stress among university students further exacerbate this issue. While physical activity helps reduce psychological symptoms, its effect on fatigue remains uncertain. Biological factors such as muscle mass and metabolic rate may provide partial protection against physical fatigue. This study explored the relationships between fatigue, depression, anxiety, and stress in university students, alongside the role of physical activity and body composition. A cross-sectional design was applied with 578 university students in Türkiye. Fatigue was assessed with the Chalder Fatigue Scale, psychological symptoms with the Depression Anxiety Stress Scale-21, and physical activity with the Physical Activity Scale-2. Data were collected face to face using a standardized protocol. Analyses included Pearson correlation, multiple linear regression, and independent samples t-tests. Findings showed that despite relatively high activity levels, students reported moderate fatigue. Fatigue was positively correlated with depression, anxiety, and stress, together explaining 36.3% of the variance, with depression showing the strongest association. Physical activity showed no direct association with fatigue, whereas skeletal muscle mass and basal metabolic rate were negatively related to physical fatigue. Female students reported higher fatigue, anxiety, and stress, while males were more active. In conclusion, fatigue in university students is primarily linked to psychological factors. No significant relationship was found between physical activity levels and fatigue, whereas fatigue was strongly associated with psychological symptoms and biological indicators. These results highlight the importance of integrating psychological support with biological health strategies to improve student well-being.
Cite this article as: Akıl, M., Güngör, M. G., & Tokay, B. (2026). Depression as a predictor of fatigue: A psychological model within the framework of physical activity and body composition. Research in Sports Science, 16, 0107, 2026. doi: 10.5152/rss.2026.25107.
M. Akıl, Melek Gülem Güngör, Bekir Tokay· Research in Sports Science· 0 citations