Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis

Simjanoski, Mario; Patel, Swara; Boni, Raquel Brandini De; Balanzá‐Martínez, Vicent; Frey, Benício N.; Minuzzi, Luciano; Kapczinski, Flávio; Cardoso, Taiane de Azevedo

doi:10.1016/j.neubiorev.2023.105257

Cited by 10 publications

(3 citation statements)

References 54 publications

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“…Regarding bipolar disorder, there are few RCTs investigating physical exercise as part of lifestyle interventions. However, the main outcome in these studies have been metabolic changes, rather than mental health improvement [ 47 – 49 ].…”

Section: Introductionmentioning

confidence: 99%

Introducing Braining—physical exercise as adjunctive therapy in psychiatric care: a retrospective cohort study of a new method

Anger,

Wallerblad,

Kaaman

et al. 2023

BMC Psychiatry

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Background Patients with severe mental disorders suffer from higher rates of poor somatic health and have shorter life expectancy than the average population. Physical activity can treat and prevent several diseases, e.g. cardiovascular and metabolic disorders as well as psychiatric symptoms. It is therefore of utmost importance to develop effective methods to integrate physical activity into psychiatric care. To meet this need, the physical activity intervention Braining was developed. This study aims to describe Braining, to assess the number of patients reached during the first years of pilot testing, to analyze clinical data in the group of patients participating in Braining 2017–2020 and to assess the intervention. Methods In this descriptive retrospective study we analyzed data from all patients participating in Braining training sessions ≥ 3 times (n = 239), the Braining Participants. Regular patients at the clinic served as a comparison. Furthermore, medical records were studied for a smaller cohort (n = 51), the Braining Pilot Cohort. Data was analyzed using Chi-square and Fisher’s tests. Results During the introduction period of Braining, 580 patients attended an information meeting about Braining, or at least one training session. 239 patients participated in ≥ 3 training sessions, considered to be participants of Braining. These Braining Participants (n = 239), ages 19 to 82, males 23.4%, attended between 3 and 308 training sessions (median 9). The main diagnoses were affective and anxiety disorders. Number of diagnoses ranged from 0 to 10 (median = 2). For the subsample, the Braining Pilot Cohort (n = 51), participants attended between 3 and 208 training sessions (median = 20). Twelve percent were working full-time, and symptom severity of depression and general anxiety was moderate. Two thirds had ≥ 3 different classes of medication. Regarding metabolic morbidity, 28 had been diagnosed with hypertension, though blood lipids, blood glucose as well as blood pressure were within the normal range. Thirty-seven percent were prescribed Physical Activity on Prescription during 2017–2020. One severe adverse event was reported. Conclusions The Braining intervention reached all age-groups and patients with a wide and representative diagnostic panorama, suggesting that Braining could be a promising and safe method for implementing physical activity in a psychiatric patient population.

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Section: Introductionmentioning

confidence: 99%

Introducing Braining—physical exercise as adjunctive therapy in psychiatric care: a retrospective cohort study of a new method

Anger,

Wallerblad,

Kaaman

et al. 2023

BMC Psychiatry

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“…Different sociodemographic, genetic, and clinical factors including psychotic symptoms [3], episode frequency [4,5], somatic conditions such as obesity [6] and metabolic syndrome [7], are assumed to contribute to cognitive deficits. In addition, lifestyle and nutrition can influence the illness course [8]. Therefore, the potential role of vitamin D on cognition in mental disorders has gained significant interest in the recent past [9,10].…”

Section: Introductionmentioning

confidence: 99%

The Influence of Vitamin D Status on Cognitive Ability in Patients with Bipolar Disorder and Healthy Controls

Leser,

Dalkner,

Tmava-Berisha

et al. 2023

Nutrients

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Recent evidence on the association between vitamin D and cognition in mentally healthy individuals is inconsistent. Furthermore, the link between vitamin D and cognitive ability in individuals with bipolar disorder has not been studied yet. Thus, we aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D), 24,25 dihydroxyvitamin D (24,25(OH)2D, the vitamin D metabolite ratio (VMR) and cognition in a cohort of euthymic patients with bipolar disorder. Vitamin D metabolites were measured simultaneously by liquid-chromatography tandem mass-spectrometry in serum samples from 86 outpatients with bipolar disorder and 93 healthy controls. Neither the inactive precursor 25(OH)D, nor the primary vitamin D catabolite 24,25(OH)2D, or the vitamin D metabolite ratio were significantly associated with the domains “attention”, “memory”, or “executive function” in individuals with bipolar disorder and healthy controls. Further, no vitamin D deficiency effect or interaction group × vitamin D deficiency was found in the cognitive domain scores. In summary, the present study does not support vitamin D metabolism as a modulating factor of cognitive function in euthymic BD patients. Considering the current study’s cross-sectional design, future research should expand these results in a longitudinal setting and include additional aspects of mental health, such as manic or depressive symptoms, long-term illness course and psychopharmacological treatment.

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“…Many patients also exhibit Nutrients 2023, 15, 4752 2 of 10 cognitive deficits associated with low everyday functioning [3]. Additionally, the illness's course can be influenced by lifestyle and nutrition [9]. Furthermore, Bauer et al (2014) described an inverse association between the age at onset of BD and the magnitude of annual variation of sunlight exposure; namely, the larger the variation of sunlight throughout the year, the earlier the onset of BD.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Status in Bipolar Disorder

Späth,

Tmava-Berisha,

Fellendorf

et al. 2023

Nutrients

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Vitamin D status may impact acute affective symptomatology and the severity of symptoms in patients with bipolar disorder (BD). Therefore, this cross-sectional study analyzed 25(OH)D, 24,25(OH)2D, and the vitamin D metabolite ratio (VMR) in BD and correlated the results with clinical affective symptomatology and functionality. The inactive precursor 25(OH)D, and its principal catabolite 24,25(OH)2D, were measured simultaneously with a validated liquid chromatography–tandem mass spectrometry method in 170 BD outpatients and 138 healthy controls. VMR was calculated as follows: VMR = 100×(24,25(OH)2D/25(OH)D). The psychometric assessment comprised: Beck Depression Inventory-II, Hamilton Depression Rating Scale, Young Mania Rating Scale, Global Assessment of Functioning, and number of suicide attempts. We did not find a significant difference between patients and controls in the concentrations of 25(OH)D and 24,25(OH)2D. Additionally, the VMR was comparable in both groups. The calculations for the clinical parameters showed a negative correlation between the Young Mania Rating Scale and 24,25(OH)2D (r = −0.154, p = 0.040), as well as the Young Mania Rating Scale and the VMR (r = −0.238, p = 0.015). Based on the small effect size and the predominantly euthymic sample, further exploration in individuals with manic symptoms would be needed to confirm this association. In addition, long-term clinical markers and an assessment in different phases of the disease may provide additional insights.

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Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis

Cited by 10 publications

References 54 publications

Introducing Braining—physical exercise as adjunctive therapy in psychiatric care: a retrospective cohort study of a new method

Introducing Braining—physical exercise as adjunctive therapy in psychiatric care: a retrospective cohort study of a new method

The Influence of Vitamin D Status on Cognitive Ability in Patients with Bipolar Disorder and Healthy Controls

Vitamin D Status in Bipolar Disorder

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