[[alternative]]運動軌跡與憂鬱情緒軌跡的性別差異：13-22歲學生的長期追蹤研究

[[abstract]]Objectives: Adolescent mental health is generally declining. Although research has revealed a negative correlation between exercise and depression, long-term studies on this topic remain limited. In this study, we used a dual-trajectory model to investigate the long-term developmental relationship between exercise trajectories and depressive mood trajectories in students (age: 13-22 years) stratified by sex. Methods: Relevant data were obtained from the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study. Our cohort comprised 1,969 individuals aged 13-22 years. Exercise trajectories and depressive mood trajectories were stratified by sex through group-based trajectory modeling; this was followed by multinomial logistic regression. Results: Exercise trajectories were classified as follows for both male and female students: consistently high, declining, and consistently low. Depressive mood trajectories were categorized into four types for male students—consistently low, mild, moderate, and consistently high— and five types for female students—consistently low, mild, moderate with a gradual increase, high with a decline, and consistently high. These trajectories differed by sex. Most male students engaged in consistently high levels of exercise (45.69%), whereas most female students engaged in consistently low levels of exercise (50.80%). Both sexes exhibited a general decline in exercise trajectories, with this beginning in junior high school for female students and in high school for male students. However, no significant association was observed between declining exercise trajectories and high depressive mood risks. Notably, the percentage of ‘consistently high depression’ group was higher among female students than among male students (14.71% vs. 9.35%), whereas that of ‘constantly low depression’ group was lower among female students than among male students (5.07% vs. 15.58%). Regardless of sex, students in the ‘consistently low exercise’ group were more likely to be consistently high depressive mood trajectory. Conclusions: Exercise trajectories and depressive mood trajectories have negative relationship in both male and female individuals. Those with high depressive mood levels in junior high school later exhibited consistently high depression levels. Thus, we recommend monitoring depressive mood from junior high school and implementing timely interventions. Enhancing exercise frequency and developing sex-sensitive policies, particularly those aimed at increasing female participation, may support adolescent mental health. (Taiwan J Public Health. 2025;44(3):269-284).