Cardiorespiratory fitness in outpatients with bipolar disorder versus matched controls: An exploratory study

Davy Vancampfort; Pascal Sienaert; Sabine Wyckaert; Michel Probst; Amber De Herdt; Marc De Hert; Brendon Stubbs; Roselien Buys

doi:10.1016/j.jad.2016.03.057

Cardiorespiratory fitness in outpatients with bipolar disorder versus matched controls: An exploratory study

J Affect Disord. 2016 Jul 15:199:1-5. doi: 10.1016/j.jad.2016.03.057. Epub 2016 Mar 29.

Authors

Davy Vancampfort¹, Pascal Sienaert², Sabine Wyckaert², Michel Probst³, Amber De Herdt³, Marc De Hert², Brendon Stubbs⁴, Roselien Buys⁵

Affiliations

¹ KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Campus Kortenberg, Belgium. Electronic address: Davy.Vancampfort@uc-kortenberg.be.
² KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Campus Kortenberg, Belgium.
³ KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.
⁴ 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.
⁵ KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, Department of Cardiovascular Sciences, Leuven, Belgium.

PMID: 27046322
DOI: 10.1016/j.jad.2016.03.057

Abstract

Background: Patients with bipolar disorder (BD) are approximately twice as likely to die prematurely due cardiovascular diseases (CVD) than the general population. Cardiorespiratory fitness (CRF) is an important health outcome measure, predictive for CVD and premature mortality.

Aims: The aim of the current study was to compare the CRF of outpatients with BD versus age-, gender-, and body mass index (BMI)-matched healthy controls (HC). A secondary aim was to assess potential correlates of CRF.

Methods: All participants underwent a maximal incremental exercise test to measure the maximum oxygen uptake (VO2max, the golden standard assessment of cardiorespiratory fitness), wore a Body Sensewear Armband for 5 subsequent days to assess their physical activity behavior and completed the Positive-and-Negative-Affect-Schedule (PANAS).

Results: Outpatients with BD (n=20; 47.8±7.6years) had a significantly lower VO2max compared with HC (n=20; 47.8±7.6years) (26.0±7.3 versus 30.4±6.5ml/min/kg, P=0.047). A higher VO2max was correlated with younger age, higher active energy expenditure, higher PANAS positive and lower PANAS negative affect scores and a lower antipsychotic medication dose.

Limitations: The limited sample and cross-sectional design preclude definitive conclusions.

Conclusions: Compared with HC, outpatients with BD have reduced CRF levels of approximately 4.4ml/min/kg. In the general population such reductions are associated with a 20% increased premature mortality risk. Interventions targeting CRF in BD are required. Although more research is needed, clinicians should consider the utility of objective assessments of CRF for risk stratification in outpatient settings.

Keywords: Bipolar disorder; Cardiovascular diseases; Fitness; Physical activity.

MeSH terms

Adult
Bipolar Disorder / complications
Bipolar Disorder / physiopathology*
Cardiorespiratory Fitness / psychology*
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / psychology
Case-Control Studies
Cross-Sectional Studies
Exercise Test / methods*
Female
Humans
Male
Middle Aged
Risk Factors
Walking / psychology*