title: Association of exercise with quality of life and mood symptoms in a comparative effectiveness study of bipolar disorder.
abstract: BACKGROUND
  Individuals with bipolar disorder lead a sedentary lifestyle associated with worse course of illness and recurrence of symptoms. Identifying potentially modifiable predictors of exercise frequency could lead to interventions with powerful consequences on the course of illness and overall health.
  
  
  METHODS
  The present study examines baseline reports of exercise frequency of bipolar patients in a multi-site comparative effectiveness study of a second generation antipsychotic (quetiapine) versus a classic mood stabilizer (lithium). Demographics, quality of life, functioning, and mood symptoms were assessed.
  
  
  RESULTS
  Approximately 40% of participants reported not exercising regularly (at least once per week). Less frequent weekly exercise was associated with higher BMI, more time depressed, more depressive symptoms, and lower quality of life and functioning. In contrast, more frequent exercise was associated with experiencing more mania in the past year and more current manic symptoms.
  
  
  CONCLUSIONS
  Exercise frequency was measured by self-report and details of the exercise were not collected. Analyses rely on baseline data, allowing only for association analyses. Directionality and predictive validity cannot be determined. Data were collected in the context of a clinical trial and thus, it is possible that the generalizability of the findings could be limited.
  
  
  CONCLUSIONS
  There appears to be a mood-specific relationship between exercise frequency and polarity such that depression is associated with less exercise and mania with more exercise in individuals with bipolar disorder. This suggests that increasing or decreasing exercise could be a targeted intervention for patients with depressive or mood elevation symptoms, respectively.
authors.affiliation: The Massachusetts General Hospital, USA. Electronic address: lsylvia2@partners.org.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Sylvia
authors.affiliation: University of Pittsburgh Medical Center, USA.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Friedman
authors.affiliation: Weill Cornell Medical College of Cornell University, USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Kocsis
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Bernstein
authors.affiliation: Weill Cornell Medical College of Cornell University, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Brody
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Kinrys
authors.affiliation: Case Western Reserve University, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Kemp
authors.affiliation: University of Alabama at Birmingham, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Shelton
authors.affiliation: Lindner Center for Hope, University of Cincinnati, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: McElroy
authors.affiliation: Mayo Clinic, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Bobo
authors.affiliation: University of Michigan, USA.
authors.forename: Masoud
authors.initials: M
authors.lastname: Kamali
authors.affiliation: University of Michigan, USA.
authors.forename: Melvin G
authors.initials: MG
authors.lastname: McInnis
authors.affiliation: University of New Mexico, USA.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.affiliation: University of Texas Health Science Center at San Antonio, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
authors.affiliation: Stanford University School of Medicine, USA.
authors.forename: Terence A
authors.initials: TA
authors.lastname: Ketter
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Thilo
authors.initials: T
authors.lastname: Deckersbach
authors.affiliation: Case Western Reserve University, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Noreen A
authors.initials: NA
authors.lastname: Reilly-Harrington
authors.affiliation: University of Texas Health Science Center at San Antonio, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Dustin J
authors.initials: DJ
authors.lastname: Rabideau
authors.affiliation: The Massachusetts General Hospital, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
mesh_terms: D000328:Adult; D000339:Affect; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy; D057186:Comparative Effectiveness Research; D003987:Dibenzothiazepines / Q000627:therapeutic use; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D000069348:Quetiapine Fumarate
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D018020:Lithium Compounds; D000069348:Quetiapine Fumarate
keywords: Bipolar disorder; Exercise; Functioning; Mood symptoms; Quality of life