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Structured physical exercise for bipolar depression: an open-label, proof-of concept study

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 uni...

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Autores principales: Lafer, Beny, Duarte, Cicera Claudinea, Greve, Julia Maria D’Andrea, dos Santos Silva, Paulo Roberto, de Almeida, Karla Mathias, Belizario, Gabriel Okawa, Neves, Lucas Melo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121991/
https://www.ncbi.nlm.nih.gov/pubmed/37085592
http://dx.doi.org/10.1186/s40345-023-00294-8
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author Lafer, Beny
Duarte, Cicera Claudinea
Greve, Julia Maria D’Andrea
dos Santos Silva, Paulo Roberto
de Almeida, Karla Mathias
Belizario, Gabriel Okawa
Neves, Lucas Melo
author_facet Lafer, Beny
Duarte, Cicera Claudinea
Greve, Julia Maria D’Andrea
dos Santos Silva, Paulo Roberto
de Almeida, Karla Mathias
Belizario, Gabriel Okawa
Neves, Lucas Melo
author_sort Lafer, Beny
collection PubMed
description 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.
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spelling pubmed-101219912023-04-23 Structured physical exercise for bipolar depression: an open-label, proof-of concept study Lafer, Beny Duarte, Cicera Claudinea Greve, Julia Maria D’Andrea dos Santos Silva, Paulo Roberto de Almeida, Karla Mathias Belizario, Gabriel Okawa Neves, Lucas Melo Int J Bipolar Disord Research 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. Springer Berlin Heidelberg 2023-04-21 /pmc/articles/PMC10121991/ /pubmed/37085592 http://dx.doi.org/10.1186/s40345-023-00294-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Lafer, Beny
Duarte, Cicera Claudinea
Greve, Julia Maria D’Andrea
dos Santos Silva, Paulo Roberto
de Almeida, Karla Mathias
Belizario, Gabriel Okawa
Neves, Lucas Melo
Structured physical exercise for bipolar depression: an open-label, proof-of concept study
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121991/
https://www.ncbi.nlm.nih.gov/pubmed/37085592
http://dx.doi.org/10.1186/s40345-023-00294-8
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