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A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders
journal contribution
posted on 2020-10-01, 00:00 authored by J Firth, M Solmi, R E Wootton, D Vancampfort, F B Schuch, Erin Hoare, S Gilbody, J Torous, S B Teasdale, S E Jackson, L Smith, M Eaton, Felice JackaFelice Jacka, N Veronese, Wolf MarxWolf Marx, G Ashdown-Franks, D Siskind, J Sarris, S Rosenbaum, A F Carvalho, B StubbsThere is increasing academic and clinical interest in how “lifestyle factors” traditionally associated with physical health may also relate to mental health and psychological well‐being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta‐review of the top‐tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta‐analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta‐reviews, and two meta‐analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress‐related disorders, schizophrenia, bipolar disorder, and attention‐deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non‐pharmacological sleep‐focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.
History
Journal
World PsychiatryVolume
19Issue
3Pagination
360 - 380Publisher
John Wiley & SonsLocation
Oxford, Eng.Publisher DOI
Link to full text
ISSN
1723-8617eISSN
2051-5545Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2020, World Psychiatric AssociationUsage metrics
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No categories selectedKeywords
Lifestyle factorsanxiety disordersbipolar disorderdepressiondietary patternsmental disordersphysical activitypsychological well-beingschizophreniasedentary behaviorsleeptobacco smokingScience & TechnologyLife Sciences & BiomedicinePsychiatryMENDELIAN RANDOMIZATIONPHYSICAL-ACTIVITYDEPRESSIVE SYMPTOMSHEALTH PROBLEMSMETAANALYSISRISKASSOCIATIONANXIETYADULTSINTERVENTIONS
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