Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Sep:152:105257.
doi: 10.1016/j.neubiorev.2023.105257. Epub 2023 May 30.

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

Mario Simjanoski  1 , Swara Patel  2 , Raquel De Boni  3 , Vicent Balanzá-Martínez  4 , Benicio N Frey  5 , Luciano Minuzzi  6 , Flavio Kapczinski  7 , Taiane de Azevedo Cardoso  8
Affiliations
Meta-Analysis

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

Mario Simjanoski et al. Neurosci Biobehav Rev. 2023 Sep.

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

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest MS, SP, TAC, BNF, RDB, and LM have nothing to disclose. VB-M has been a consultant, advisor or Continuing Medical Education (CME) speaker over the last 3 years for the following companies: Angelini, Lundbeck, and Nutrición Médica, all of them unrelated to the present work. FK has been a consultant for Janssen - Johnson & Johnson, unrelated to the present work.