Association of Concurrent Clusters of Physical Inactivity and Unhealthy Lifestyle Habits with Common Mental Disorders among Primary Healthcare Workers: Insights from a large sample cross-sectional analysis in Brazil.

BACKGROUND

Common mental disorders (CMDs) are highly prevalent worldwide. Leisure time physical inactivity (LTPI) is a key modifiable behavior increasingly recognized for its contribution to CMD risk, alongside tobacco use, alcohol consumption, and nonparticipation in social activities (NPSA). Despite this, most studies examine these lifestyle factors individually rather than investigating their concurrent clustering and combined impact on mental health.

OBJECTIVE

To examine the association between clusters of unhealthy lifestyle habits centered on LTPI and CMDs among primary healthcare workers (PHCWs) in the state of Bahia, Brazil.

METHODS

A cross-sectional analysis of 3,343 PHCWs was conducted. CMDs were screened with the Self-Report Questionnaire-20. Unhealthy behaviors (LTPI, tobacco use, alcohol use, and NPSA) were analyzed individually and as clusters (observed/expected ratios). Associations with CMDs were estimated via logistic regression.

RESULTS

Participants were predominantly female (78.9%); 57.1% were ≤40 years. Prevalences were as follows: LTPI: 56.6%, tobacco: 6.2%, alcohol: 37.3%, NPSA: 61.3%; and CMDs: 22.6%. LTPI [odds ratio (OR) = 1.56; 95% confidence interval (CI): 1.23-1.99], and NPSA (OR = 1.60; 95% CI: 1.27-2.03) were independently associated with CMDs. The LTPI + NPSA cluster showed higher odds of CMDs (OR = 1.73; 95% CI: 1.29-2.31). Clustering patterns also revealed combinations involving LTPI and tobacco use.

CONCLUSION

CMDs among PHCWs are linked not only to single behaviors but to clusters centered on LTPI, particularly when combined with social isolation. Mental health strategies in primary care settings should prioritize increasing leisure time physical activity and social engagement alongside broader lifestyle risk reduction.