Motivation Towards Exercise and 24-Hour Movement Behaviours in In-Patients with Depression

Introduction: Prior research has shown the role of physical actvity in depression is vital, and that autonomous motivation toward exercise is linked with higher self-reported physical activity in psychiatric in-patients. However, emerging evidence suggests that considering 24-hour movement behaviours – encompassing physical activity, sedentary behaviour, and sleep – may better support mental health. This study aimed to evaluate motivational regulation towards exercise and objectively measured 24-hour movement behaviours in in-patients with depression, and to explore their interrelationships.

Methods: This cross sectional study included adult participants (18–65 years) with depressive symptoms (Beck Depression Inventory [BDI]>10) at intake into a psychiatric clinic in Switzerland. Exercise motivation was assessed using the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2). Movement behaviours were monitored over 6 days using wrist-worn accelerometers (GENEActiv). Descriptive statistics and Spearman correlations were used to examine associations between motivation types and movement variables.

Results: 29 participants (44.8% female, mean BDI 24.04, 8.74 Standard Deviation [SD]) were recruited. Participants averaged 162.5 minutes/day of moderate-to-vigorous physical activity (MVPA, 62.94min SD), overreaching physical activity guideline recommendations. However, sleep duration (382.2 minutes/night, 72.74min SD) and sleep efficiency (70.6%, 7.8% SD) were below recommended thresholds, and sedentary behaviour (679.2 minutes/day, 101.17min SD) was higher than recommended. Sedentary behaviour was negatively associated with both sleep efficiency (R=–0.398, p=0.0336) and total sleep time (R=–0.347, p=0.0659). Autonomous regulation (AR) and introjected regulation (IR) were positively correlated with MVPA, while amotivation (AM) showed a significant negative association (AR: R=0.583, p=0.001, IR: R=0.502, p=0.006, AM: R=–0.362, p=0.0536). No significant associations were found between motivational regulation and sedentary time.

Conclusion: Despite participants achieving recommended levels of physical activity, elevated sedentary time and suboptimal sleep parameters indicate that focusing solely on MVPA may overlook critical aspects of movement health. Further, these findings suggest that even introjected motivation may suffice to promote MVPA during psychiatric in-patient care, though sustainability post-discharge remains uncertain. An integrated 24-hour movement approach – addressing physical activity, sedentary behaviour, and sleep – and addressing motivation towards exercise may be needed for effectively promoting mental well-being, aligning with prior recommendations in this field.

Publication History

Article published online:
23 October 2025