Louisa G Sylvia1, Samantha L Pegg2, Steven C Dufour2, Jessica A Janos2, Emily E Bernstein3, Weilynn C Chang4, Nathan E Hall5, Kristen K Ellard6, Andrew A Nierenberg6, Thilo Deckersbach6. 1. Massachusetts General Hospital, Department of Psychiatry, Dauten Family Center for Bipolar Treatment Innovation, 50 Staniford Street, Suite 580, Boston, MA 02114, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States. Electronic address: lsylvia2@partners.org. 2. Massachusetts General Hospital, Department of Psychiatry, Dauten Family Center for Bipolar Treatment Innovation, 50 Staniford Street, Suite 580, Boston, MA 02114, United States. 3. Harvard University, Department of Psychology, 33 Kirkland Street, Cambridge, MA 02138, United States. 4. McLean Hospital, Gunderson Residence, 115 Mill Street, Belmont, MA 02478, United States. 5. Massachusetts General Hospital, Department of Psychiatry, Dauten Family Center for Bipolar Treatment Innovation, 50 Staniford Street, Suite 580, Boston, MA 02114, United States; Harvard University, Department of Biostatistics, 677 Huntington Avenue, Boston, MA 02115, United States. 6. Massachusetts General Hospital, Department of Psychiatry, Dauten Family Center for Bipolar Treatment Innovation, 50 Staniford Street, Suite 580, Boston, MA 02114, United States; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States.
Abstract
BACKGROUND: Individuals with bipolar disorder (BD) are more likely than the general population to develop risk factors associated with cardiovascular disease, one of the leading causes of morbidity and mortality in this clinical population. To address this disproportionate medical burden, we developed Nutrition Exercise and Wellness Treatment (NEW Tx), a lifestyle intervention for individuals with BD. METHODS: In this study, participants were randomized to NEW Tx (n = 19) or a treatment as usual waitlist (n = 19). We examine the intervention's efficacy to improve the physical and psychological outcomes of individuals with BD. Assessors were blind to participant condition throughout study duration. RESULTS: The NEW Tx group reported increased weekly exercise duration and overall functioning, and decreased depression and illness severity over the study duration. However, only improvements in functioning were significantly greater in the NEW Tx group than in the control group. There were no group differences in weight loss or mood symptoms over the study duration. LIMITATIONS: Limitations to this study include lack of objective measurement of exercise and a small and relatively homogeneous sample. CONCLUSIONS: These data suggest that a manualized lifestyle intervention for BD may not be ideal to improve lifestyle changes in this clinical population. Further research is needed to pilot personalized approaches to creating a healthy lifestyle in BD.
RCT Entities:
BACKGROUND: Individuals with bipolar disorder (BD) are more likely than the general population to develop risk factors associated with cardiovascular disease, one of the leading causes of morbidity and mortality in this clinical population. To address this disproportionate medical burden, we developed Nutrition Exercise and Wellness Treatment (NEW Tx), a lifestyle intervention for individuals with BD. METHODS: In this study, participants were randomized to NEW Tx (n = 19) or a treatment as usual waitlist (n = 19). We examine the intervention's efficacy to improve the physical and psychological outcomes of individuals with BD. Assessors were blind to participant condition throughout study duration. RESULTS: The NEW Tx group reported increased weekly exercise duration and overall functioning, and decreased depression and illness severity over the study duration. However, only improvements in functioning were significantly greater in the NEW Tx group than in the control group. There were no group differences in weight loss or mood symptoms over the study duration. LIMITATIONS: Limitations to this study include lack of objective measurement of exercise and a small and relatively homogeneous sample. CONCLUSIONS: These data suggest that a manualized lifestyle intervention for BD may not be ideal to improve lifestyle changes in this clinical population. Further research is needed to pilot personalized approaches to creating a healthy lifestyle in BD.
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Authors: Louisa G Sylvia; Jessica A Janos; Samantha L Pegg; Steven C Dufour; Weilynn C Chang; Emily E Bernstein; Brett Davis; Kristen K Ellard; Thilo Deckersbach; Andrew A Nierenberg Journal: J Psychiatr Pract Date: 2019-11 Impact factor: 1.841
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