Exercise interventions may be needed in bipolar patients

By Eleanor McDermid, Senior medwireNews Reporter

An accelerometry study shows that patients with bipolar disorder tend to be mostly sedentary.

During a week of monitoring, the research team found that more than three-quarters of the participants’ time was classified as sedentary – about 13.5 hours of the average 17-hour daily monitoring time.

Most of the rest of the monitoring time was accounted for by light physical activity, with moderate or vigorous activity accounting for just 1.4%. Men tended to engage in more moderate/vigorous activity than women, but only by an average of 9 minutes per day.

None of the patients achieved the guideline-recommended 150 minutes of moderate/vigorous activity per week, note lead study author Carol Janney (University of Pittsburgh School of Medicine, Philadelphia, USA) and team.

The researchers say theirs is the first study to report objectively measured physical activity in outpatients with bipolar disorder.

“Although causality cannot be established given the current study design, these novel findings imply that lack of physical activity may be one factor increasing the risk of common medical comorbidities in adults with [bipolar disorder] and suggest that physical activity interventions in this high-risk population are indicated,” they write in the Journal of Affective Disorders.

The team notes, however, that most of their patients had well-controlled symptoms, with just 13% experiencing moderate or severe depression and none having moderate or severe mania. Thus, they may not give an accurate guide to the amount of exercise taken by a more general population of bipolar disorder patients.

Besides being below current recommendations, the patients’ physical activity levels were also low relative to an external control group drawn from the National Health and Nutrition Examination Survey (NHANES) 2003–2004. This comprised 60 mental health service users and 60 nonusers, who accumulated an average daily sedentary time of 66% and 59% of total monitoring, respectively, compared with 78% among bipolar disorder patients.

The NHANES groups did only very slightly more moderate/vigorous physical activity than the bipolar disorder patients, at 1.9% and 2.5% of total time, respectively, but engaged in significantly more light physical activity.

“From public health and clinical perspectives, these findings justify physical activity interventions targeting adults with [bipolar disorder],” say Janney et al.

“Physical activity may also be an effective behavioral intervention for the treatment and/or management of mood episodes and the corresponding impairments in quality of life, and occupational and social functioning observed in adults with [bipolar disorder].”

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