Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: A systematic review

Abstract

Background Bipolar disorder (BD) is a serious mental illness associated with a high risk of medical comorbidities, long-term disability and premature death. This systematic review examined the current literature on therapeutic interventions targeting nutrition and physical activity in BD and collecting health-related measures such as mood and course of illness. Methods Scopus (all databases), Pubmed and Ovid Medline were systematically searched with no language or year restrictions, up to June 2015, for studies focusing on lifestyle interventions in BD. Search terms were related to bipolar disorder, nutrition, physical activity, wellbeing, psychosocial interventions and course of illness. We hand searched content pages of Bipolar Disorders and Journal of Affective Disorders and checked references of relevant reviews and dissertations to identify additional papers. Results After applying inclusion and exclusion criteria to identified hits, this literature search retrieved six papers. Overall findings point towards a beneficial role of lifestyle interventions on mood, weight, blood pressure, lipid profile, physical activity and overall wellbeing. Methodological limitations include small sample size, gender ratio imbalance, inconsistencies in terms of laboratory measures, and lack of randomized control trials and absence of follow-up and longitudinal studies to determine the benefits of these factors on clinical and functional outcomes over time Conclusions Lifestyle interventions in BD targeting nutrition, exercise, wellbeing alongside beliefs, coping strategies and attitudes towards health show promise in reducing the risk of comorbid ailments in BD. There is still a strong need for studies a) developing interventions which are informed by the patient’s input and b) examining the effectiveness of such interventions targeting general wellness using well-controlled trials.

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

“…Unhealthy lifestyle habits, such as impaired sleep, poor diet, sedentary behaviour, smoking and substance/alcohol misuse are associated with increased inflammation and impaired neuroplasticity; and are known to increase mood symptoms and cardio‐metabolic burden in mood disorders . All of these behaviours are modifiable, with growing evidence indicating that multimodal lifestyle interventions targeting exercise, nutrition and wellness are feasible and effective in improving physical and emotional health in BD . Surprisingly, the relationship between lifestyle factors and cognition has not received much research attention.…”

“…123 All of these behaviours are modifiable, with growing evidence indicating that multimodal lifestyle interventions targeting exercise, nutrition and wellness are feasible and effective in improving physical and emotional health in BD. 124 Surprisingly, the relationship between lifestyle factors and cognition has not received much research attention.…”

Treatment of Psychiatric Symptoms Among Offspring of Parents With Bipolar Disorder

“…It is important to obtain a detailed history of patient’s symptoms, triggers, family history and promote healthy lifestyle habits including regular exercise, adequate sleep, and proper nutrition [33]. Sedentary lifestyle is a common problem among individuals with Bipolar Disorder [34] and may consequently affect youth offspring living with a Bipolar Disorder parent.…”

Primary care management of cardiovascular risk for people with severe mental illnesses: the Primrose research programme including cluster RCT

“…32 Systematic reviews of interventions to increase uptake of lifestyle behaviours found some beneficial impact on CVD risk factors; however, the methodological quality of many of the included studies was low. [33][34][35] Most studies target single-risk factors and do not seek to address the full CVD risk profile of patients with SMI. Only one trial was found that tested a life goals collaborative care intervention involving management strategies for mental health symptoms and CVD risk factors.…”