Related Experiment Videos
Cognitive performance and self-reported physical exercise in bipolar disorder: A cross-sectional analysis of
Gabriel Okawa Belizario1, Fernanda Mayumi Del Mastro Espíndola1, Cícera Claudinea Duarte1
1Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Brazil.
Background:
Bipolar Disorder (BD) is frequently associated with persistent cognitive deficits that significantly impair functionality and quality of life. While physical exercise (PE) has shown promise in improving cognition in healthy individuals and those with other psychiatric conditions, most consistently in major depressive disorder and schizophrenia, its specific impact on individuals with BD remains under-investigated. This study aimed to investigate the association between self-reported regular physical exercise and cognitive performance in individuals with Bipolar Disorder.
Methods:
This study consists of a cross-sectional analysis of pre-randomization screening data from an ongoing randomized controlled trial. The analysis included 108 euthymic BD individuals (aged 18-55) recruited from the outpatient clinic at the University of São Paulo Medical School (PROMAN). Participants were allocated into either the Exercise Group (n = 48), defined by self-reported engagement in regular structured physical exercise at least twice a week, and the No-Exercise Group (n = 60); exercise status was ascertained with a brief in-house checklist. Cognitive performance was assessed using the Screen for Cognitive Impairment in Psychiatry (SCIP). Secondary measures included mood symptoms (MADRS and YMRS) and pharmacological treatment profiles. Effect sizes were estimated with Cohen's d, and a Bonferroni-corrected threshold of α = 0.0033 was applied to the 15 comparisons performed.
Results:
The Exercise group demonstrated significantly higher SCIP Total Scores compared to the No-Exercise group (64.63 ± 9.19 vs. 56.50 ± 7.84; p < 0.001, d = 0.95). Significant advantages for the exercise group were observed in sub-domains related to verbal learning (p = 0.010) and working memory (p = 0.002); the total score and working memory remained significant after Bonferroni correction, whereas verbal learning did not. Notably, the No-Exercise group had a significantly higher usage of stimulants (27.5% vs. 4.5%, p = 0.029), while the Exercise group had a higher prevalence of anticonvulsant use (45.5% vs. 20%, p = 0.035); neither medication difference survived correction.
Limitations:
Exercise status was self-reported and dichotomous, with no data on intensity, duration or modality, and no demographic or clinical covariates were available for adjustment.
Conclusion:
Regular physical exercise appears to be associated with superior global cognition, verbal learning, and working memory in individuals with BD. These findings, derived from the screening phase of an ongoing trial, suggest that PE may be a promising adjunctive strategy for neurocognitive rehabilitation, although the cross-sectional design precludes any causal inference.
