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

McMaster University. Neuroscience Graduate Program. Hamilton, ON, Canada / McMaster University. Department of Psychiatry and Behavioural Neurosciences. Hamilton, ON, Canada.
McMaster University. School of Interdisciplinary Science. Life Sciences Program. Hamilton, ON, Canada.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
University of Valencia. Teaching Unit of Psychiatry and Psychological Medicine. Department of Medicine. CIBERSAM. Valencia, Spain.
McMaster University. Neuroscience Graduate Program. Hamilton, ON, Canada / McMaster University. Department of Psychiatry and Behavioural Neurosciences. Hamilton, ON, Canada / Women’s Health Concerns Clinic and Mood Disorders Program. St. Joseph’s Healthcare. Hamilton, ON, Canada.
McMaster University. Neuroscience Graduate Program. Hamilton, ON, Canada / McMaster University. Department of Psychiatry and Behavioural Neurosciences. Hamilton, ON, Canada / University of Valencia. Teaching Unit of Psychiatry and Psychological Medicine. Department of Medicine. CIBERSAM. Valencia, Spain.
McMaster University. Neuroscience Graduate Program. Hamilton, ON, Canada / McMaster University. Department of Psychiatry and Behavioural Neurosciences. Hamilton, ON, Canada / Instituto Nacional de Ciência e Tecnologia Translacional em Medicina. Porto Alegre, RS, Brasil.
McMaster University. Department of Psychiatry and Behavioural Neurosciences. Hamilton, ON, Canada / McMaster University. School of Interdisciplinary Science. Life Sciences Program. Hamilton, ON, Canada.

Abstract

This review and meta-analysis aimed to describe the existing literature on interventions for bipolar disorder (BD) targeting the 6 pillars of Lifestyle Psychiatry: diet, physical activity (PA), substance use (SU), sleep, stress management, and social relationships (SR). Randomized Controlled Trials that examined the efficacy of lifestyle interventions targeting improvement in depressive/(hypo)manic symptom severity, lifestyle patterns, functioning, quality of life, and/or circadian rhythms were included. The systematic review included 18 studies, while the meta-analysis included studies targeting the same lifestyle domains and outcomes. Sleep (n = 10), PA (n = 9), and diet (n = 8) were the most targeted domains, while SU, SM and SR were least targeted (n = 4 each). Combined diet and PA interventions led to significant improvements in depressive symptoms (SMD: − 0.46; 95% CI: − 0.88, − 0.04; p = 0.03), and functioning (SMD: − 0.47; 95%CI: − 0.89, − 0.05; p = 0.03). Sleep interventions also led to significant improvements in depressive symptoms (SMD: − 0.80; 95%CI: − 1.21, − 0.39; p < 0.01). Future research should focus on developing more multidimensional lifestyle interventions for a potentially greater impact on clinical and functional outcomes of BD.

Keywords

Bipolar disorder
Lifestyle interventions
Systematic review
Meta-analysis
RCT
Lifestyle psychiatry
Lifestyle medicine
Diet
Exercise
Substance use
Stress
Sleep
Social relationships

Publisher

Elsevier

Citation

SIMJANOSKI, Mario et al. Lifestyle interventions for bipolar disorders: a systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, v. 152, p. 1-13, Sept. 2023.

DOI

10.1016/j.neubiorev.2023.105257

ISSN

0149-7634

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/59434

Type

Copyright

Restricted access

Embargo date

2030-12-31

Collections

Share

Statistics

Metadata

Author

Affilliation