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Publications

Journal Article Review Consensus Statement Ppublish 2 citations

PubMed: 42545207 DOI: 10.1111/bdi.70164

Sedentary Behavior and Physical Activity in Individuals With Bipolar Disorder: An Evidence Synthesis and Position Statement From the ISBD Nutrition and Exercise Task Force (NExT).

Bipolar Disord 28(5):e70164

Authors: Beny Lafer, Lucas M Neves, Davy Vancampfort, Brendon Stubbs, Ana Gonzalez-Pinto, Andrew Nierenberg, Andrew T Olagunju, Benjamin I Goldstein, Eduard Vieta, Elena Koning, Fabiano A Gomes, Gayatri Saraf, Jess G Fiedorowicz, Lakshmi N Yatham, Louisa Sylvia, Maj Vinberg, Manuel Gardea-Resendez, Marco Solmi, Mark A Frye, Michael Berk, Mohammad Alsuwaidan, Rodrigo B Mansur, Roumen Milev, Simon Rosenbaum, Tamsyn Van Rheenen, Vicent Balanzá-Martínez, Wolfgang Marx, Felipe Schuch, Elisa Brietzke

Affiliations

  • Bipolar Disorder Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
  • Department of Physical Education, São Paulo State University (UNESP), Rio Claro, Brazil.
  • Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
  • Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
  • Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria.
  • Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
  • Division of Psychology and Mental Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
  • Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
  • Hospital Universitario de Alava, BIOARABA, EHU, CIBERSAM, Vitoria, Spain.
  • Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Department of Psychiatry and Behavioral Neurosciences, McMaster University/St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
  • Department of Psychiatry and Behavioral Sciences, University of Oklahoma, Oklahoma City, OK, USA.
  • Discipline of Psychiatry, Adelaide University, Adelaide, South Australia, Australia.
  • Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Ontario, Canada.
  • Institute of Neuroscience, University of Barcelona, Hospital Clinic, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
  • Department of Psychiatry, Queen's University School of Medicine, Kingston, Ontario, Canada.
  • Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
  • The Ottawa Hospital and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  • Department of Psychiatry, University of British Columbia, Vancouver, Canada.
  • The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Denmark.
  • Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.
  • Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
  • Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ontario, Canada.
  • Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
  • Department of Psychiatry & Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
  • Deakin Institute for Mental and Physical Health and Clinical Translation (Deakin IMPACT), School of Medicine, Deakin University, Geelong, Australia.
  • Mental Health Drug and Alcohol Services, Barwon Health, University Hospital Geelong, Geelong, Australia.
  • Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
  • MindWell Center, Kuwait City, Kuwait.
  • Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
  • Department of Psychiatry, Centre for Neuroscience Studies, Queen's University, Providence Care, Kingston, Ontario, Canada.
  • Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.
  • Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Australia.
  • Centre for Mental Health and Brain Sciences, Swinburne University, Hawthorn, Victoria, Australia.
  • Teaching Unit of Psychiatry, Department of Medicine, University of Valencia, Valencia, Spain.
  • Deakin Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.
  • Institute for Mental and Physical Health and Clinical Translation (IMPACT) and Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia.

Abstract

BACKGROUND

Higher time in sedentary behavior and insufficient physical activity are very common in bipolar disorder (BD). Whereas physical activity and exercise offer significant benefits across mental health, brain health, and heart health in BD. The International Society for Bipolar Disorders Nutrition and Exercise Task Force (NExT) synthesized evidence to evaluate the impacts of sedentary behavior, physical activity, and exercise on illness course, physical health, and treatment outcomes.

METHODS

A best-evidence synthesis was conducted using a question-and-answer format. We searched PsycINFO, SPORTDiscus, Embase, PubMed, and Web of Science from inception to March 1st, 2026, supplemented by reference lists and existing guidelines. Search terms included combinations of physical activity, exercise, sedentary behavior, and bipolar disorder-related terms.

RESULTS

Observational studies show that individuals with BD exhibit significantly higher sedentary behavior and lower physical activity compared to the general population, with notable discrepancies between self-reported and objective measurements. Evidence on physical activity's protective role against BD onset is mixed, with some prospective and Mendelian randomization studies suggesting reduced risk, while others report bidirectional or null associations. Preliminary findings from clinical trials indicate that exercise improves overall functioning, reduces mood episode frequency and hospitalizations, and alleviates depressive symptoms, with one pilot study showing an 82% antidepressant response rate. Exercise also shows potential to reduce anxiety and improve sleep, though robust data are limited.

CONCLUSIONS

Despite limited high-quality evidence, physical activity and exercise demonstrate promising physical and mental health benefits for individuals with BD. Future research should prioritize multicenter randomized controlled trials, enhanced assessment tools, and accessible, tailored programs to integrate physical activity into routine BD management.

MeSH

Depression, Exercise, Mania, Bipolar Disorder, Sedentary Behavior, Mental Health