The effects of physical activity in the acute treatment of bipolar disorder: a pilot study

J Affect Disord. 2007 Aug;101(1-3):259-62. doi: 10.1016/j.jad.2006.11.014. Epub 2006 Dec 19.


Background: Physical activity has demonstrated efficacy in depression and anxiety, but its potential in the management of bipolar disorder is yet unexplored. This study is a pilot investigation into the effectiveness of an adjunctive walking program in the acute treatment of bipolar disorder.

Methods: This is a retrospective cohort study of all patients admitted over a 24-month period to a private psychiatric unit with a primary diagnosis of bipolar disorder (ICD-10). All patients were invited to participate voluntarily in a walking group during their admissions. Those who reliably attended the walking group (participants) were compared against those who did not attend (non-participants), using the clinician-rated Clinical Global Impression Severity (CGI-S) and Improvement (CGI-I) scales and the self-reported 21-item Depression Anxiety Stress Scales (DASS) as primary outcome measures.

Results: There were 24 admissions for participants and 74 admissions for non-participants. The two groups did not differ significantly in patient demographics or admission CGI and DASS measures, except for a lower DASS Stress subscore for participants (p=0.049). At discharge, the inter-group differences in CGI measures remained non-significant, but participants had significantly lower scores than non-participants for DASS (p=0.005) and all its subscales (Depression p=0.048, Anxiety p=0.002, Stress p=0.01).

Limitations: Methodological limitations include a retrospective design, small sample size, lack of randomisation or control, and indirect measure of manic symptoms.

Conclusions: The results of this trial provide preliminary support for a therapeutic role of physical activity in bipolar disorder, and warrant further investigation with randomised controlled trials.

MeSH terms

  • Acute Disease
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Anxiety / therapy
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / psychology
  • Bipolar Disorder / therapy*
  • Cohort Studies
  • Combined Modality Therapy
  • Depression / diagnosis
  • Depression / psychology
  • Depression / therapy
  • Exercise / psychology*
  • Humans
  • Patient Admission
  • Personality Inventory
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Treatment Outcome
  • Walking / psychology