INTRODUCTION

Adolescents are more vulnerable to depression, psychoses, and suicidal thoughts (^{Avanci, Assis, Oliveira, Ferreira, & Pesce, 2007}), which motivates research on mental health during youth. A previous study observed that 13.4% of children and adolescents have some mental disorder (^{Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015}), constituting a fact that can influence behaviours, including suicidal ideation, which is the presence of thoughts and ideas of engaging in action to kill oneself (^{Baiden & Tadeo, 2020}). Suicidal ideation is one of the risk factors associated with suicide attempts (^{Victor & Klonsky, 2014}). The suicide rates of young people between 10 and 24 years can range from 2.9% to 5.4%, depending on the region, knowing that these rates could be higher if underreporting did not occur (^{Machado & Santos, 2015}).

Recent research indicates the existence of a positive relationship between physical activity and mental health (^{Pascoe et al., 2020}), placing physical activity as a possible protective factor against mental health problems in adolescents (^{Guo, Tomson, Keller, & Söderqvist, 2018}; ^{Lourenço, Peres, Porto, Oliveira, & Dutra, 2017}). However, research erroneously encompasses physical activity, exercises, and sports in the same category (^{Bezerra, Lopes, Del Duca, Barbosa Filho, & Barros, 2016}; ^{Pinheiro, Andrade, & De Micheli, 2016}), and such habits have distinct characteristics.

Evaluating studies related to sports practice indicates that adolescents who practice sports have better mental health indicators (^{Badura, Geckova, Sigmundova, van Dijk, & Reijneveld, 2015}) and are less likely to suffer from depression, suicidal ideation (^{Babiss & Gangwisch, 2009}), and anxiety (^{Graupensperger, Sutcliffe, & Vella, 2021}). In addition, adolescents involved in sports during elementary and high school were less likely to report suicidal ideation during high school when compared to those who never participated in sports (^{Taliaferro, Eisenberg, Johnson, Nelson, & Neumark-Sztainer, 2011}). However, it is noteworthy that the type of sports practice (team or individual) can interfere with mental health outcomes. In the study by ^{Pluhar et al. (2019)}, the report of anxiety and depression was higher in individual sports athletes and among athletes of the female sex than in team sports athletes. Team sports practitioners also had lower rates of suicidal thoughts and suicide attempts (^{Harrison & Narayan, 2003}).

However, still be slightly explored differences between group and individual sports in the literature (^{Panza et al., 2020}; ^{Taliaferro et al., 2011}). According to a recent systematic review of 29 studies involving sports participation in adolescents and symptoms of anxiety or depression, of which only seven categorized the sport as team and individual (^{Panza et al., 2020}), even though their different internal and external characteristics are evident, such as planning, interaction, techniques, tactics, and psychological issues (^{Dantas, 2014}). Thus, it is still unclear how group and individual sports relate to mental health and suicidal ideation (^{Panza et al., 2020}).

Mental health is multifactorial and may be associated with factors such as gender, age (^{Lopes et al., 2016}), socioeconomic status (^{Jansen et al., 2011}), and family relationships (^{Benetti, Pizetta, Schwartz, Hass, & Melo, 2010}). Thus, this study aimed to analysed the association between different types of physical activity (systematized exercise, individual, and collective sports), mental health, and suicidal ideation in adolescents.

METHOD

RESULTS

We examined 687 adolescents from 20 classes (10 in the morning, 05 in the afternoon, and 05 in the night shifts). However, 14 parents refused the invitation, and we excluded seven questionnaires from students under 14 and over 19 years old. Thus, the final sample included 666 adolescents. Table 1 presents the demographic and socioeconomic characteristics of the sample. It is noteworthy that some study variables have a lower amount than the final sample because, concerning their ethical rights, some students chose not to answer some questions in the questionnaire, which were classified in this research as missing.    

Higher prevalence was observed related to mental disorders (54.2% vs. 32.5%), difficulties related to mental health (79.6% vs. 48.4%), and suicidal thoughts (22.9% vs. 11.4%) in girls than in boys (p < .001 for all; Table 1).

There was a strong association between good relationships with parents and variables related to mental health (mental health difficulties, symptoms of common mental disorders, and suicidal ideation; Figure 1). In addition, it was noted that young people who reported being dissatisfied with their relationship with their parents were more likely to have common mental disorders (OR = 4.4; 95% CI = [2.6, 7.4]), mental health-related difficulties (OR = 3.8; 95% CI = [2.0, 7.4]), and to have suicidal thoughts (OR = 5.3; 95% CI = [3.1, 8.9]) when compared those who reported being satisfied with the relationship with their parents, showing themselves as an essential control variable (Figure 1).We did not find a significant association between the relationship with friends and the variables related to mental health.    

Figure 1 Prevalence of the satisfaction index of relationships with parents and friends and their associations with the common mental disorder, mental health, and suicidal ideation of adolescents.OR. Odds ratio; 95 CI: Confifence interval 95%; * p < .001. 

The need for stratification by gender was verified after testing the interaction. Thus, we observed that boys who practiced team sports were less likely to have common mental disorders (OR = .41; 95% CI = [.20, .85]) and suicidal ideation (OR = .26; 95% CI = [.09, -.72]) after adjusting for potential confounding factors (Table 2). On the other hand, we did not find a significant association between leisure-time physical activities and mental health-related problems in the girls (Table 2).    

DISCUSSION AND CONCLUSION

The main results of this study were: a) good relationship with parents minimizes the chances of adolescents having mental health-related problems; b) higher prevalence was observed related to mental disorders, difficulties related to mental health, and suicidal thoughts in girls; c) the practice of team sports was associated with fewer symptoms of common mental disorders, lower mental health problems, and less suicidal ideation only among boys, independently of age, family income, relationship with parents, and relationships with friends.

We noted that adolescents with a good relationship with their parents had fewer mental health problems. Reinforcing this finding, a study conducted with 658 students aged between 14 and 17 years found that young people were less exposed to risky behaviours when parents were aware of their children’s habits and placed limits and rules on them (^{Wang, 2013}). Thus, good relationships with parents can curb common aggressive or sexual impulses of adolescence, behaviours that can correlate with mental health problems and a good relationship with parents improves well-being and health (^{Fonseca, 1997}).

In the present study, we found that girls are more vulnerable to problems related to mental health. Similarly, ^{Saud and Tonelotto (2005)} observed that girls experience more emotional problems, which may reflect the characteristics of the cultural environment in which they are inserted. In addition, it has been seen that early pubertal time in girls can have an impact on mental health, as found in a study that accompanied 7802 American girls, noting that those who had earlier menarche presented the beginning of adulthood in psychopathology, even after considering the demographic and contextual variables commonly associated with vulnerability to mental health (^{Mendle, Ryan, & McKone, 2018}). In this sense, we found evidence that the puberty time of girls is an essential factor related to mental health and thereby can partly explain this greater vulnerability compared to boys.

Curiously, we observed that only team sports were associated with fewer psychiatric symptoms in the practice of leisure-time physical activity. Previous studies have shown that physical activity can prevent mental problems. For example, an 11-year prospective follow-up study with nearly 34,000 volunteers, using univariate and multivariate logistic regression, demonstrated that regular physical activity, regardless of intensity, appeared to prevent depression but not anxiety disorders (^{Harvey et al., 2018}). Also, a meta-analysis of 49 prospective studies showed that physical activity protects against the onset of depression, regardless of age and region (^{Schuch et al., 2018}). Moreover, it emphasizes that sports have peculiar characteristics which go beyond exercise. Sports have, in their essence, discipline, the development of competencies, behaviors, attitudes, and values (^{Eagleton, McKelvie, & de Man, 2007}). When such values are added to group work, this practice helps directly in maturing and favors the development of mental health, as shown in studies where observed that the participation of children and adolescents in team sports is associated with better psychological health than individual sports (^{Eime, Young, Harvey, Charity, & Payne, 2013}; ^{Pluhar et al., 2019}).

Unlike individual sports, the game actions in team sports are always performed in direct cooperation with teammates, with varied environments and tactical-strategic aspects (^{Oliveira & Tavares, 1996}).Thus, team sports help develop the collective spirit, stimulate social interaction, develop reasoning and intelligence, and help in discipline as generated by respect for rules, opponents, and their companions (^{Rose Júnior, 2006}).

Interestingly, the relationship between team sports with mental health and suicidal ideation was only observed among boys. Such a point may be related to motivational factors since the present competitiveness in sports is more valued by boys (^{Kopcakova et al., 2015}). In addition, boys deal with the conflicts which commonly occur during sports practice more naturally than girls, and the possible provocations related to the appearance or incoordination which can occur during such practice can make girls feel bad, and consequently, they have a repulsion to the sport (^{Weiss & Smith, 2002}).

The main limitation of this study was the cross-sectional design, and the correlative nature of the data precluded us from establishing a causal relationship between leisure-time physical activity and mental health. Also, we did not control the time of practice of the activity performed by adolescents because the questionnaire does not evaluate this point, but so far it is not known whether the variables respond differently to depend on the time of practice. In this sense, we speculate, given the scarcity of the literature, that the time of practice may be important to evaluate the chronic effects of physical exercise and sports practices on mental health-related variables. However, even aware of the limitation of the cross-sectional design of the present study, our result drives us to think that socialization related to practice seems to have a more significant impact on mental health (^{Andersen, Ottesen, & Thing, 2019}; ^{Eime et al., 2013}) and not physiological changes, changes usually associated with the time of practice. In this sense, it would be interesting for future studies to make adaptations in the questionnaires to assess whether the time of practice can affect adolescentsʼ mental health. Finally, it should be considered that presenting symptoms of mental disorders does not necessarily imply that there is a psychiatric diagnosis to be treated.

The representative sample can be pointed to as one of the strengths of this study since the sampling procedures were established to ensure that the population was composed of adolescent students attending schools in different shifts. In addition, we evaluated different forms of practice of physical activities (exercises, team, or individual sports) and their impact on mental health after adjusting for potential confounding variables.

In conclusion, we observed a higher prevalence of mental disorders, difficulties related to mental health and suicidal thoughts in girls. Among the different forms of physical activity (exercises, team, or individual sports), only the practice of team sports was associated with fewer symptoms of common mental disorders, lower mental health problems, and less suicidal ideation, however, only among boys.