title: The effects of physical activity in the acute treatment of bipolar disorder: a pilot study.
abstract: BACKGROUND
  Physical activity has demonstrated efficacy in depression and anxiety, but its potential in the management of bipolar disorder is yet unexplored. This study is a pilot investigation into the effectiveness of an adjunctive walking program in the acute treatment of bipolar disorder.
  
  
  METHODS
  This is a retrospective cohort study of all patients admitted over a 24-month period to a private psychiatric unit with a primary diagnosis of bipolar disorder (ICD-10). All patients were invited to participate voluntarily in a walking group during their admissions. Those who reliably attended the walking group (participants) were compared against those who did not attend (non-participants), using the clinician-rated Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I) scales and the self-reported 21-item Depression Anxiety Stress Scales (DASS) as primary outcome measures.
  
  
  RESULTS
  There were 24 admissions for participants and 74 admissions for non-participants. The two groups did not differ significantly in patient demographics or admission CGI and DASS measures, except for a lower DASS Stress subscore for participants (p=0.049). At discharge, the inter-group differences in CGI measures remained non-significant, but participants had significantly lower scores than non-participants for DASS (p=0.005) and all its subscales (Depression p=0.048, Anxiety p=0.002, Stress p=0.01).
  
  
  CONCLUSIONS
  Methodological limitations include a retrospective design, small sample size, lack of randomisation or control, and indirect measure of manic symptoms.
  
  
  CONCLUSIONS
  The results of this trial provide preliminary support for a therapeutic role of physical activity in bipolar disorder, and warrant further investigation with randomised controlled trials.
authors.affiliation: Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria, Australia. felicitn@barwonhealth.org.au
authors.forename: Felicity
authors.initials: F
authors.lastname: Ng
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000208:Acute Disease; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015444:Exercise / Q000523:psychology*; D006801:Humans; D010343:Patient Admission; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome; D016138:Walking / Q000523:psychology