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

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...

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Published in:Neuroscience and biobehavioral reviews 2023-09, Vol.152, p.105257-105257, Article 105257
Main Authors: Simjanoski, Mario, Patel, Swara, Boni, Raquel De, Balanzá-Martínez, Vicent, Frey, Benicio N., Minuzzi, Luciano, Kapczinski, Flavio, Cardoso, Taiane de Azevedo
Format: Article
Language:English
Subjects:
Bipolar disorder
Bipolar Disorder - therapy
Diet
Exercise
Humans
Life Style
Lifestyle interventions
Lifestyle medicine
Lifestyle psychiatry
Meta-analysis
Psychotherapy
Quality of Life
RCT
Sleep
Social relationships
Stress
Substance use
Systematic review
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Summary: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 
ISSN:0149-7634
1873-7528
DOI:10.1016/j.neubiorev.2023.105257