Melanie M Ashton1,2,3, Mohammadreza Mohebbi4, Alyna Turner1,5, Wolfgang Marx1,6, Michael Berk1,3,5,7,8, Gin S Malhi9,10,11, Chee H Ng2, Sue M Cotton7,8, Seetal Dodd1,5,7, Jerome Sarris2,12, Malcolm Hopwood13, Brendon Stubbs14,15, Olivia M Dean1,3. 1. IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia. 2. Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Richmond, Victoria, Australia. 3. The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia. 4. Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia. 5. School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia. 6. Department of Rehabilitation, Nutrition and Sport, School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia. 7. Centre of Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia. 8. Orygen, Parkville, Victoria, Australia. 9. Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, New South Wales, Australia. 10. Faculty of Medicine and Health, Department of Psychiatry, Northern Clinical School, University of Sydney, New South Wales, Australia. 11. CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia. 12. NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia. 13. Professorial Psychiatry Unit, Albert Road Clinic, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. 14. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom. 15. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
Abstract
OBJECTIVES:Individuals with bipolar disorder (BD) generally engage in low levels of physical activity (PA), and yet few studies have investigated the relationship between PA and change in BD symptom severity. The aim of this subanalysis of an adjunctive nutraceutical randomized controlled trial for the treatment of bipolar depression was to explore the relationship between PA, the active adjunctive treatments (a nutraceutical "mitochondrial cocktail"), and clinical outcomes. METHODS:Participants with bipolar depression were randomized to receive N-acetylcysteine alone, N-acetylcysteine with a combination of nutraceuticals (chosen for the potential to increase mitochondrial activity), or placebo for 16 weeks. Participants (n = 145) who completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF; measured at Week 4) were included in this exploratory subanalysis. Assessments of BD symptoms, functioning, and quality of life were completed at monthly visits up until Week 20. Generalised Estimating Equations were used to explore whether IPAQ-SF scores were a moderator of treatment received on outcomes of the study. RESULTS: Week-4 PA was not related to changes in Montgomery Åsberg Depression Rating Scale scores across the study until Week 20. However, participants who engaged in more PA and who received the combination treatment were more likely to have a reduction in scores on the Bipolar Depression Rating Scale (P = 0.03). However, this was not consistent in all domains explored using the IPAQ-SF. Participants who engaged in higher levels of PA also experienced greater improvement in social and occupational functioning and less impairment in functioning due to their psychopathology and improvement in quality of life at Week 20, irrespective of treatment. CONCLUSIONS: This study provides novel evidence of the association between PA and reduction in BD symptoms in a nutraceutical clinical trial. However, further research assessing the potential synergistic effects of PA in BD is required.
RCT Entities:
OBJECTIVES: Individuals with bipolar disorder (BD) generally engage in low levels of physical activity (PA), and yet few studies have investigated the relationship between PA and change in BD symptom severity. The aim of this subanalysis of an adjunctive nutraceutical randomized controlled trial for the treatment of bipolar depression was to explore the relationship between PA, the active adjunctive treatments (a nutraceutical "mitochondrial cocktail"), and clinical outcomes. METHODS:Participants with bipolar depression were randomized to receive N-acetylcysteine alone, N-acetylcysteine with a combination of nutraceuticals (chosen for the potential to increase mitochondrial activity), or placebo for 16 weeks. Participants (n = 145) who completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF; measured at Week 4) were included in this exploratory subanalysis. Assessments of BD symptoms, functioning, and quality of life were completed at monthly visits up until Week 20. Generalised Estimating Equations were used to explore whether IPAQ-SF scores were a moderator of treatment received on outcomes of the study. RESULTS: Week-4 PA was not related to changes in Montgomery Åsberg Depression Rating Scale scores across the study until Week 20. However, participants who engaged in more PA and who received the combination treatment were more likely to have a reduction in scores on the Bipolar Depression Rating Scale (P = 0.03). However, this was not consistent in all domains explored using the IPAQ-SF. Participants who engaged in higher levels of PA also experienced greater improvement in social and occupational functioning and less impairment in functioning due to their psychopathology and improvement in quality of life at Week 20, irrespective of treatment. CONCLUSIONS: This study provides novel evidence of the association between PA and reduction in BD symptoms in a nutraceutical clinical trial. However, further research assessing the potential synergistic effects of PA in BD is required.
Authors: Gerwyn Morris; Ken Walder; Sean L McGee; Olivia M Dean; Susannah J Tye; Michael Maes; Michael Berk Journal: Neurosci Biobehav Rev Date: 2017-01-14 Impact factor: 8.989
Authors: F T Fellendorf; N Kainzbauer; M Platzer; N Dalkner; S A Bengesser; A Birner; R Queissner; P Rauch; C Hamm; R Pilz; E Z Reininghaus Journal: J Affect Disord Date: 2017-06-21 Impact factor: 4.839
Authors: Felipe B Schuch; Davy Vancampfort; Joseph Firth; Simon Rosenbaum; Philip B Ward; Edson S Silva; Mats Hallgren; Antonio Ponce De Leon; Andrea L Dunn; Andrea C Deslandes; Marcelo P Fleck; Andre F Carvalho; Brendon Stubbs Journal: Am J Psychiatry Date: 2018-04-25 Impact factor: 18.112
Authors: Michael Berk; Alyna Turner; Gin S Malhi; Chee H Ng; Susan M Cotton; Seetal Dodd; Yuval Samuni; Michelle Tanious; Claire McAulay; Nathan Dowling; Jerome Sarris; Lauren Owen; Astrid Waterdrinker; Deidre Smith; Olivia M Dean Journal: BMC Med Date: 2019-01-25 Impact factor: 8.775
Authors: Anna Giménez-Palomo; Seetal Dodd; Gerard Anmella; Andre F Carvalho; Giselli Scaini; Joao Quevedo; Isabella Pacchiarotti; Eduard Vieta; Michael Berk Journal: Front Psychiatry Date: 2021-07-06 Impact factor: 4.157