A Long Time Coming - The Creation of an Evidence Base for Physical Activity Prescription to Improve Health Outcomes in Bipolar Disorder.
A Long Time Coming - The Creation of an Evidence Base for Physical Activity Prescription to Improve Health Outcomes in Bipolar Disorder.
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期待已久 - 为身体活动处方创建证据基础，以改善双相情感障碍的健康结果。
DOI：
10.1016/j.mhpa.2010.01.001
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发表时间：
2010
影响因子：
4.7
通讯作者：
Kilbourne,AmyM
中科院分区：
文献类型：
--
作者：
Goodrich,DavidE;Kilbourne,AmyM
虽然已经发表了几篇关于体力活动和心境障碍的有益作用的综述（例如，Daley，2008），但关于体力活动作为严重精神障碍（特别是双相情感障碍）患者的预防性治疗作用的临床研究并不常见。这种空白可能反映了一个历史事实，即大多数关于身体活动和心理健康之间关系的研究都是在运动科学实验室进行的，这可能会排除那些患有严重精神疾病的人，如双相情感障碍。对严重精神疾病患者的研究是谨慎进行的，这是由于对加重患者症状或拥有足够的临床培训来管理潜在的精神病不良事件的伦理考虑。尽管在过去十年中越来越多的人认识到双相情感障碍给社会带来了巨大的健康负担，部分原因是这种疾病患者患心血管疾病的风险很大（Fagiolini，Chengappa，Soreca，& Chang，2008; Kupfer，2005），旨在解决这些身体健康差异的行为健康干预措施已经落后。对于严重的精神疾病如双相情感障碍，缺乏基础或应用的身体活动研究甚至更令人惊讶，因为身体活动经常被推荐为改善患者结果的基本治疗（美国糖尿病协会，美国精神病学协会，美国临床内分泌学家协会和北美肥胖研究协会，2004; De Hert等人，2009; Fagiolini & Goracci，2009），包括多组分临床试验（例如，基尔本、Post、Nossek、Drill等，2008年）。此外，双相情感障碍产生独特的特征，使身体活动干预对这一群体很重要。值得注意的是，患有这种疾病的人经历了广泛的功能和抑郁和躁狂的交替时期，前者导致久坐不动的生活方式，后者导致过度行为，如暴饮暴食，可能导致体重增加。
While there have been several reviews published on the beneficial effects of physical activity and mood disorders (eg, Daley, 2008), clinical research into the role of physical activity as an adjunctive treatment for persons with serious mental disorders, notably bipolar disorder, has been less common. This void probably reflects the historical fact that most research on the relationship between physical activity and mental health was conducted in exercise science labs, which may have precluded those with serious mental illness such as bipolar disorder from participating. Research on patients with serious mental illness was approached cautiously due to ethical concerns about aggravating patient symptoms or possessing adequate clinical training to manage potential psychiatric adverse events.Despite increased recognition over the past decade that bipolar disorder imposes a tremendous health burden on society due in part to the substantial risk for cardiovascular disease among persons with this condition (Fagiolini, Chengappa, Soreca, & Chang, 2008; Kupfer, 2005), behavioral health interventions designed to address these physical health disparities have lagged. The absence of basic or applied physical activity research studies for serious mental illnesses such as bipolar disorder is even more surprising given that physical activity is frequently recommended as an essential treatment for improving patient outcomes (American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, & North American Association for the Study of Obesity, 2004; De Hert, et al., 2009; Fagiolini & Goracci, 2009) including in multi-component clinical trials (eg, Kilbourne, Post, Nossek, Drill, et al., 2008). Moreover, bipolar disorder engenders unique characteristics that make physical activity interventions important for this group. Notably, persons with this illness experience a wide range of functioning and alternating periods of depression and mania, the former leading to sedentary lifestyle and the latter leading to excessive behaviors such as overeating that can lead to weight gain.