Association between adherence to a healthy lifestyle and firefighters' depression and posttraumatic stress disorder in Taiwan: A longitudinal, prospective cohort study.
Preventive medicine reports · 2025-12-05 · Observational study
Abstract
OBJECTIVE: To investigate how an integrated healthy lifestyle can affect firefighters' mental health. METHODS: We prospectively followed a firefighter cohort in Taiwan from 2023 to 2024. We surveyed participants' adherence to a healthy lifestyle at baseline using a validated modified Mediterranean lifestyle score (MEDI-Lifestyle score, range: 0-7, encompassing non-obesity, no smoking, sufficient sleep and naps, adequate physical activity, reduced sedentary time, and quality diet). Mental health was repeatedly measured using the revised Beck Depression Inventory for Primary Care (BDI-PC, range: 0-18), Patient Health Questionnaire (PHQ-8, range: 0-24), and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5, range: 0-76). We built mixed-effects models to investigate the longitudinal associations. RESULTS: Among the 349 firefighters that participated in both years' surveys (retention rate: 71 %), a 1-point increment in the baseline modified MEDI-Lifestyle score was correlated with average score changes of -0.41 (95 % confidence interval [CI]: -0.64, -0.18), -0.55 (95 % CI: -0.85, -0.25), and - 1.47 (95 % CI: -2.42, -0.52) on the BDI-PC, PHQ-8, and PCL-5 after model adjustment, respectively, during the follow-up period. Regarding individual lifestyle behaviors, sufficient sleep and napping played key roles in the associations. CONCLUSIONS: A healthier lifestyle is significantly correlated with more favorable mental health scores among Taiwanese firefighters.