Sedentary Behavior and Physical Activity in Individuals With Bipolar Disorder: An Evidence Synthesis and Position Statement From the ISBD Nutrition and Exercise Task Force (NExT)
Year: 2026
Type: article
Abstract: BACKGROUND: Higher time in sedentary behavior and insufficient physical activity are very common in bipolar disorder (BD). Whereas physical activity and exercise offer significant benefits across mental health, brain health, and heart health in BD. The International Society for Bipolar Disorders Nutrition and Exercise Task Force (NExT) synthesized evidence to evaluate the impacts of sedentary behavior, physical activity, and exercise on illness course, physical health, and treatment outcomes. METHODS: A best-evidence synthesis was conducted using a question-and-answer format. We searched PsycINFO, SPORTDiscus, Embase, PubMed, and Web of Science from inception to March 1st, 2026, supplemented by reference lists and existing guidelines. Search terms included combinations of physical activity, exercise, sedentary behavior, and bipolar disorder-related terms. RESULTS: Observational studies show that individuals with BD exhibit significantly higher sedentary behavior and lower physical activity compared to the general population, with notable discrepancies between self-reported and objective measurements. Evidence on physical activity's protective role against BD onset is mixed, with some prospective and Mendelian randomization studies suggesting reduced risk, while others report bidirectional or null associations. Preliminary findings from clinical trials indicate that exercise improves overall functioning, reduces mood episode frequency and hospitalizations, and alleviates depressive symptoms, with one pilot study showing an 82% antidepressant response rate. Exercise also shows potential to reduce anxiety and improve sleep, though robust data are limited. CONCLUSIONS: Despite limited high-quality evidence, physical activity and exercise demonstrate promising physical and mental health benefits for individuals with BD. Future research should prioritize multicenter randomized controlled trials, enhanced assessment tools, and accessible, tailored programs to integrate physical activity into routine BD management.
Source: Bipolar Disorders
DOI: 10.1111/bdi.70164
Authors: Beny Lafer, Lucas M. Neves, Davy Vancampfort, Brendon Stubbs, Ana Gonzalez‐Pinto, Andrew Nierenberg, Andrew T. Olagunju, Benjamin I. Goldstein, Eduard Vieta, Elena Koning, Fabiano A. Gomes, Gayatri Saraf, Jess G. Fiedorowicz, Lakshmi N. Yatham, Louisa Sylvia, Maj Vinberg, Manuel Gardea‐Resendez, Marco Solmi, Mark A. Frye, Michael Berk, Mohammad Alsuwaidan, Rodrigo B. Mansur, Roumen Milev, Simon Rosenbaum, Tamsyn Van Rheenen, Vicent Balanzá‐Martínez, Wolfgang Marx, Felipe Schuch, Elisa Brietzke
Institutions: Universidade de São Paulo, Universidade Estadual Paulista (Unesp), KU Leuven, King's College London, Manchester Academic Health Science Centre, University of Manchester, Medical University of Vienna, Charité – Universitätsmedizin Berlin, University of the Basque Country, Centro de Investigación Biomédica en Red de Salud Mental, Harvard University, Massachusetts General Hospital, Adelaide University, The University of Adelaide, St. Joseph’s Healthcare Hamilton, University of Oklahoma, McMaster University, Centre for Addiction and Mental Health, University of Toronto, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Queen's University, Ottawa Hospital, Ottawa Hospital Research Institute, University of British Columbia, University of Copenhagen, Mental Health Services, Copenhagen University Hospital, Universidad Autónoma de Nuevo León, University of Ottawa, Mayo Clinic, Barwon Health, Deakin University, The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Geelong Hospital, Orygen, UNSW Sydney, Swinburne University of Technology, Universitat de València
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,730
Funders: U.S. Department of Defense, American Foundation for Suicide Prevention, Eli Lilly and Company, Sanofi, Heart and Stroke Foundation of Canada, Biogen, Patient-Centered Outcomes Research Institute, Teva Pharmaceutical Industries, Fondation Brain Canada, Sunovion, PA Research Foundation, Wellcome Trust, LivaNova, Centre for Addiction and Mental Health Foundation, Ministerio de Ciencia, Innovación y Universidades, Equity Trustees, Bond University, Physicians' Services Incorporated Foundation, Australian Rotary Health, La Trobe University, Deakin University, Fundação de Amparo à Pesquisa do Estado de São Paulo, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Dainippon Sumitomo Pharma, Eusko Jaurlaritza, Gedeon Richter, Euskal Herriko Unibertsitatea, Lundbeckfonden, University of Toronto, Conselho Nacional de Desenvolvimento Científico e Tecnológico, State Government of Victoria, Ministerio de Ciencia e Innovación, Ministério da Educação, Society for Mental Health Research, Centro de Investigación Biomédica en Red de Salud Mental, Servier, H. Lundbeck A/S, Bausch Health, Idorsia Pharmaceuticals, National Institutes of Health, Health Resources and Services Administration, Department of Psychiatry, University of Toronto, Canadian Institutes of Health Research, National Health and Medical Research Council, Cancer Council Queensland, Instituto de Salud Carlos III, European Regional Development Fund, Southeastern Ontario Academic Medical Organization, Congressionally Directed Medical Research Programs, Cilag, Medical Research Future Fund
Awards: TRASTORNO BIPOLAR, ESTILO DE VIDA Y ESTRÉS OXIDATIVO, Development of a bench to bedside platform for novel therapy development for psychiatric disorders, G1934591525, G22113365, G2416132163, G2739718152, Nutritional Psychiatry: Investigation and translation of personalised nutritional therapies for depression, G4644209160, Protecting physical & mental health of trauma-exposed populations, ESTILO DE VIDA EN PRIMER EPISODIO MANIACO Y POTENCIACION FUNCIONAL, G5654507885, G6033524483, G6326635400, G6844139850, G713478339, Estilos de vida y aptitud física y sus correlatos biológicos como marcadores de síntomas de depresión y ansiedad en estudiantes universitarios: estudio de casos y controles anidado en la Cohorte UNILIFE-M
OpenAlex ID: W7172254530