title: Physical activity and sedentary behavior in people with bipolar disorder: A systematic review and meta-analysis.
abstract: Mortality rates are approximately two to three times higher in people with bipolar disorder (BD) than in general population. Lack of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality.
  
  
  
  We conducted a meta-analysis to investigate PA and SB levels and its predictors in BD.
  
  
  
  Major electronic databases were searched from inception till 02/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in BD. A random effects meta-analysis and meta-regression analysis were conducted.
  
  
  
  Six studies were eligible including 279 (129♂) people with BD (mean age=43.9 years; range: 32.0-51.5 years). The trim and fill analysis demonstrated people with BD spent in total 210.1min (95%CI=146.3-273.9min) per day being physically active and 613.3min (95%CI=389.9-836.6min) during waking hours being sedentary. No significant difference in total PA per day was observed between people with BD and controls (g=-0.62, 95% CI=-1.55 to 0.31, I(2)=88.5%, n BD =82, n controls =86). Objective measures of PA recorded significantly lower levels (P=0.03) compared to self-report PA. Meta-regression demonstrated that older age and a higher body mass index predicted lower PA levels.
  
  
  
  Only a limited number of studies were identified assessing SB in people with BD.
  
  
  
  Adults with BD engage in high levels of sedentary behavior during waking hours. Given that sedentary behavior is an independent predictor of cardiovascular disease, future lifestyle interventions specifically targeting the prevention of sedentary behavior are warranted.
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Kortenberg, Belgium. Electronic address: Davy.Vancampfort@uc-kortenberg.be.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors.forename: Joseph
authors.initials: J
authors.lastname: Firth
authors.affiliation: Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Programa de Pós-Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Schuch
authors.affiliation: Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Rosenbaum
authors.affiliation: KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Kortenberg, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: De Hert
authors.affiliation: Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda.
authors.forename: James
authors.initials: J
authors.lastname: Mugisha
authors.affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Probst
authors.affiliation: Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D015992:Body Mass Index; D016208:Databases, Factual; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D057185:Sedentary Behavior; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Bipolar disorder; Exercise; Physical activity; Sedentary behavior