Structured physical exercise for bipolar depression: an open-label, proof-of concept study
Abstract Background Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD)...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-04-01
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| Series: | International Journal of Bipolar Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40345-023-00294-8 |
| _version_ | 1797841195085332480 |
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| author | Beny Lafer Cicera Claudinea Duarte Julia Maria D’Andrea Greve Paulo Roberto dos Santos Silva Karla Mathias de Almeida Gabriel Okawa Belizario Lucas Melo Neves |
| author_facet | Beny Lafer Cicera Claudinea Duarte Julia Maria D’Andrea Greve Paulo Roberto dos Santos Silva Karla Mathias de Almeida Gabriel Okawa Belizario Lucas Melo Neves |
| author_sort | Beny Lafer |
| collection | DOAJ |
| description | Abstract Background Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD. Methods This is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12. Results The mean (± SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 ± 8.3 points and after 12 weeks of PE the mean score was 10.2 ± 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen’s D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test − 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis). Conclusions This study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies. |
| first_indexed | 2024-04-09T16:27:08Z |
| format | Article |
| id | doaj.art-21b8e6a78122424ba9d8bd9bc3093514 |
| institution | Directory Open Access Journal |
| issn | 2194-7511 |
| language | English |
| last_indexed | 2024-04-09T16:27:08Z |
| publishDate | 2023-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | International Journal of Bipolar Disorders |
| spelling | doaj.art-21b8e6a78122424ba9d8bd9bc30935142023-04-23T11:04:11ZengSpringerOpenInternational Journal of Bipolar Disorders2194-75112023-04-0111111010.1186/s40345-023-00294-8Structured physical exercise for bipolar depression: an open-label, proof-of concept studyBeny Lafer0Cicera Claudinea Duarte1Julia Maria D’Andrea Greve2Paulo Roberto dos Santos Silva3Karla Mathias de Almeida4Gabriel Okawa Belizario5Lucas Melo Neves6Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical SchoolBipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical SchoolMovement Studies Laboratory, Department of Orthopedics and Traumatology, University of São Paulo Medical SchoolMovement Studies Laboratory, Department of Orthopedics and Traumatology, University of São Paulo Medical SchoolBipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical SchoolBipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical SchoolBipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical SchoolAbstract Background Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD. Methods This is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12. Results The mean (± SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 ± 8.3 points and after 12 weeks of PE the mean score was 10.2 ± 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen’s D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test − 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis). Conclusions This study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies.https://doi.org/10.1186/s40345-023-00294-8Physical activityPhysical exerciseMental healthBipolar disorderDepression |
| spellingShingle | Beny Lafer Cicera Claudinea Duarte Julia Maria D’Andrea Greve Paulo Roberto dos Santos Silva Karla Mathias de Almeida Gabriel Okawa Belizario Lucas Melo Neves Structured physical exercise for bipolar depression: an open-label, proof-of concept study International Journal of Bipolar Disorders Physical activity Physical exercise Mental health Bipolar disorder Depression |
| title | Structured physical exercise for bipolar depression: an open-label, proof-of concept study |
| title_full | Structured physical exercise for bipolar depression: an open-label, proof-of concept study |
| title_fullStr | Structured physical exercise for bipolar depression: an open-label, proof-of concept study |
| title_full_unstemmed | Structured physical exercise for bipolar depression: an open-label, proof-of concept study |
| title_short | Structured physical exercise for bipolar depression: an open-label, proof-of concept study |
| title_sort | structured physical exercise for bipolar depression an open label proof of concept study |
| topic | Physical activity Physical exercise Mental health Bipolar disorder Depression |
| url | https://doi.org/10.1186/s40345-023-00294-8 |
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