Exercise may not be ‘one size fits all’ in bipolar patients

By Eleanor McDermid, Senior medwireNews Reporter

Researchers say that more study is needed of the relationship between exercise and symptoms among patients with bipolar disorder.

In a preliminary study of 482 patients from a multicenter, randomized trial, Louisa Sylvia (Massachusetts General Hospital, Boston, USA) and colleagues found that the amount of exercise patients undertook was strongly linked to their mood.

Sixty percent of patients said they exercised at least once a week, but the amount of exercise they did declined with the severity of depression. For example, the amount of exercise taken fell by 0.2 days per week with every 10-point increase in Bipolar Inventory of Symptoms Scale depression score. Furthermore, the amount of exercise taken declined in line with increasing proportion of the previous year spent depressed, even after controlling for current mood.

The opposite effect was seen for mania, with the amount of exercise taken rising with increasing mania symptoms and proportion of the previous year spent manic or hypomanic. Mixed episodes were also associated with increased exercising.

Patients who took more exercise also reported better life functioning and quality of life. However, the amount of exercise was also related to current mood episode, leading Sylvia and co-workers to warn of “a complex relationship between bipolar disorder and physical activity.”

They cite suggestions that exercise could have mixed effects for bipolar patients in manic phases, by helping them to regulate emotion and structure their lives, but also by stimulating them and further disrupting their mood.

“In short, more research is needed to understand the relationship between exercise and bipolar disorder,” the researchers write in the Journal of Affective Disorders.

They say: “Overall, the present study illustrates that exercise regimes may not be a ‘one size fits all’ intervention, but rather an intervention that requires personalization to meet the specific needs of bipolar patients.”

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