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 that examined the efficacy of lifestyle interventions targeting improvement in depressive/(hypo)manic symptom severity, lifestyle patterns, func-tioning, 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.

Automated summary

This review and meta-analysis examine interventions targeting the 6 pillars of Lifestyle Psychiatry for bipolar disorder. The study found that sleep, physical activity, and diet were the most targeted domains, while substance use, stress management, and social relationships were least targeted. Combined diet and physical activity interventions showed significant improvement in depressive symptoms and functioning. Sleep interventions also led to significant improvements in depressive symptoms. Future research should focus on developing multidimensional lifestyle interventions for better outcomes.