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目的:基于全国代表性样本，探索中国20～79岁居民心理健康现状及其与体育锻炼的关系。方法:以第五次国民体质监测中161 901名20～79岁居民为研究对象开展横断面调查，其中包含121 928名20～59岁成年人和39 973名60～79岁老年人；通过心理健康指标综合问卷评估其心理健康状况，调查体育锻炼参与情况、锻炼频率和时长。使用SPSS 26.0进行统计学分析，采用卡方检验和Logistic回归分析检验体育锻炼与心理健康的关系。结果:中国20～79岁居民的抑郁症状检出率为16.6%(26 311/158 518)。其中，20～59岁成年人抑郁、焦虑症状检出率分别为18.0%(21 465/119 409)和13.8%(16 435/119 444)，经常或总是感到压力者占比为15.3%(18 373/120 444)；60～79岁老年人抑郁症状检出率为12.4%(4 846/39 109)，孤独感量表得分>25分者占比为32.8%(12 650/38 525)，经常或总是感到压力者占比为4.0%(1 587/39 395)。Logistic回归分析显示，与不参加体育锻炼者相比，参加体育锻炼者抑郁症状风险降低了20%( β＝－0.22， OR＝0.80，95% CI：0.78～0.82)。随着体育锻炼频率和强度的增加，向好趋势更为明显，每周锻炼至少3 d且中等强度以上者，抑郁症状检出率降低了35%( β＝－0.39， OR＝0.65，95% CI：0.63～0.67)。亚组分析结果显示，体育锻炼与抑郁的负相关性在成年人和老年人、男性和女性、城镇和乡村人群中均存在。参加体育锻炼的成年人焦虑风险检出率降低6%( β＝－0.06， OR＝0.94，95% CI：0.91～0.97)、每周锻炼≥3 d且中等强度以上者降低15%( β＝－0.16， OR＝0.85，95% CI：0.81～0.89)。未观察到参与体育锻炼与压力风险检出率存在关联( P>0.05)，但随着锻炼频率和强度增加其积极效应同样出现。参与体育锻炼的老年人有高孤独感得分的风险降低了50%( β＝－0.70， OR＝0.50，95% CI：0.47～0.52)、压力风险检出率降低了35%( β＝－0.43， OR＝0.65，95% CI：0.59～0.72)。 结论:参加体育锻炼的人群表现出更加积极、健康的心理和情绪状态。运动能够积极有效地预防和改善心理健康。

Objective:To explore the mental health level of Chinese adults aged 20~79 years and its association with exercise based on the surveillance data.Methods:A cross-sectional study was conducted in a total of 161 901 samples from the Fifth National Physical Fitness Surveillance, including 121 928 adults aged 20-59 years and 39 973 elderly aged 60-79 years. The mental health status was assessed by a comprehensive questionnaire, and the participation in frequency and duration of exercise were investigated. Chi-square test and Logistic regression were applied to test the relationship between exercise and mental health using SPSS 26.0 software.Results:The rate of depressive symptoms among residents aged 20-79 years in China was 16.6%(26 311/158 518). In the adults aged 20-59 years, the rates of depression and anxiety symptoms were 18.0%(21 465/119 409) and 13.8%(16 435/119 444), respectively, and the proportion of those who often or always felt stressed was 15.3%(18 373/120 444). In the elderly aged 60-79 years, the rate of depression symptoms was 12.4%(4 846/39 109), the proportion of those with loneliness scale scores higher than 25 was 32.8%(12 650/38 525), and 4.0%(1 587/39 395) elderly often or always felt stressed. Compared with the non-exercisers, the risk of depression symptoms in the exercisers was reduced by 20% ( β=-0.22, OR=0.80, 95% CI: 0.78-0.82). With increased frequency and intensity of physical exercise, the mental health condition improved significantly. For those who exercised at least 3 days a week and had moderate intensity or above, the detection rate of depression symptoms decreased by 35% ( β=-0.39, OR=0.65, 95% CI: 0.63-0.67).The negative associations between exercise and depression were found in different ages, genders and resident subgroups. The risk of anxiety was 6% lower in the adults who participated in physical activity ( β=-0.06, OR=0.94, 95% CI: 0.91-0.97) and 15% lower in those who exercised over 3 days per week at moderate-to-vigorous intensity ( β=-0.16, OR=0.85, 95% CI: 0.81-0.89). No association between exercise and risk of stress was observed ( P>0.05), but the positive effect was also found as exercise frequency and intensity increased. Older adults with exercise had a reduced risk of high loneliness scores by 50% ( β=-0.70, OR=0.50, 95% CI: 0.47-0.52) and a 35% lower detection of stress risk ( β=-0.43, OR=0.65, 95% CI: 0.59-0.72). Conclusion:Exercise was significantly and meaningfully associated with self-reported mental health.Exercise can actively and effectively prevent and improve mental health.