Understanding the relationship between time spent outdoors, mental well-being and health-related behaviours in a Spanish sample: A real time smartphone-based study

Ana Catalan; Stefania Tognin; Ryan Hammoud; Claudia Aymerich; Borja Pedruzo; Amaia Bilbao-Gonzalez; Gonzalo Salazar de Pablo; Malein Pacho; Paolo Fusar-Poli; Miguel Ángel Gonzalez-Torres

doi:10.1016/j.psychres.2023.115494

Understanding the relationship between time spent outdoors, mental well-being and health-related behaviours in a Spanish sample: A real time smartphone-based study

Psychiatry Res. 2023 Nov:329:115494. doi: 10.1016/j.psychres.2023.115494. Epub 2023 Sep 25.

Affiliations

¹ Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK. Electronic address: ana.catalanalcantara@osakidetza.eus.
² Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK; Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK.
³ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK.
⁴ Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
⁵ OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain.
⁶ Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bilbao, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain; Department of Medicine, Faculty of Health Sciences, University of Deusto, Bilbao, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain.
⁷ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Italy; Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, London, UK.
⁸ Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Italy; Outreach and Support in South-London (OASIS) service, South London and Maudlsey (SLaM) NHS Foundation Trust, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
⁹ Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.

PMID: 37783095
DOI: 10.1016/j.psychres.2023.115494

Abstract

Introduction: COVID-19 pandemic has affected our lifestyle and physical and mental well-being. We aimed to study the effect of being outdoors and mental well-being after the COVID-19 pandemic.

Material and methods: We used smartphone based ecological momentary assessments (EMA) (Urban Mind app) to study the mental well-being of the Spanish general population. We collected socio-demographic data, past and current physical and mental health, and social and physical environment. Participants were recruited during 5 months (February to June 2021). Longitudinal associations between EMA and anxiety, depression, loneliness, tiredness, and happiness during the assessments were investigated using random intercept ordinal logistic regression models.

Results: 274 subjects downloaded the app and completed the baseline assessment. 66 participants completed at least 50 % of the assessments. Being outdoors was related to a lower likelihood of anxiety (OR: 0.48, 95 %CI 0.34-0.66), depression (OR: 0.40, 95 %CI 0.28-0.56), tiredness (OR: 0.47, 95 %CI 0.35-0.63), and loneliness (OR: 0.59, 95 %CI 0.42-0.84), and a higher likelihood of happiness (OR: 2.14, 95 %CI 1.57-2.93).

Conclusions: Being outdoors is related to better mental health in the general population independently of other factors (baseline mental well-being or socio-demographic characteristics). Public policies should include measurements to promote outdoor spaces in urban settings.

Keywords: Anxiety; COVID-19; Depression; Mental well-being; Outdoors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Fatigue / epidemiology
Health Behavior
Humans
Mental Health*
Pandemics
Smartphone