This study examined whether participation in school team sports, exclusively or in combination with other extracurricular activities, is associated with higher levels of psychosocial functioning and healthy behavior than participation in other extracurricular activities alone or nonparticipation. The study sample includes 50,168 ninth grade public school students who completed an anonymous, voluntary statewide survey in 2001. Students were classified into four groups based on their participation in sports and other activities (such as clubs, volunteer work, band, choir, or music lessons): neither, both, other activities only, and sports only. Odds ratios for the group involved in both types of activities were significantly higher than those for all the other groups for all healthy behaviors and measures of connectedness, and significantly lower for all but one of the unhealthy behaviors. Students involved in sports, alone or in combination with other activities, had significantly higher odds than the other two groups for exercise, milk consumption, and healthy self-image, and significantly lower odds for emotional distress, suicidal behavior, family substance abuse, and physical and sexual abuse victimization. Students involved in other activities, alone or in combination with sports, had significantly higher odds than the other two groups for doing homework and significantly lower odds for alcohol consumption, marijuana use, and vandalism. The finding that abuse victims appeared to avoid sports but not other group activities raises concern and merits further research. Considering the potential benefits of participation in sports and other activities, more research is needed to identify and overcome barriers or deterrents, particularly for youth from low-income families.

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BackgroundItem 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.MethodsWe conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.Results16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).ConclusionsPHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.

Women who continued to use alcohol or drugs after learning they were pregnant were more frequent users than spontaneous quitters, more likely to smoke cigarettes, and had more psychosocial stressors. Achieving higher rates of cessation may require approaches that simultaneously address substance use and impediments to quitting. Higher continuation rates among some cultural groups require further investigation.