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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

Authors
  • Firth, Joseph1, 2
  • Solmi, Marco3
  • Wootton, Robyn E.4
  • Vancampfort, Davy5, 6
  • Schuch, Felipe B.7
  • Hoare, Erin8
  • Gilbody, Simon9
  • Torous, John10
  • Teasdale, Scott B.11
  • Jackson, Sarah E.12
  • Smith, Lee13
  • Eaton, Melissa2
  • Jacka, Felice N.14
  • Veronese, Nicola15
  • Marx, Wolfgang14
  • Ashdown‐Franks, Garcia16, 17, 18
  • Siskind, Dan19, 20
  • Sarris, Jerome2, 21
  • Rosenbaum, Simon11
  • Carvalho, André F.22, 16
  • And 1 more
  • 1 University of Manchester, UK , (United Kingdom)
  • 2 Western ‐Sydney University, Australia , (Australia)
  • 3 University of Padua, Italy , (Italy)
  • 4 University of Bristol, UK , (United Kingdom)
  • 5 KU Leuven Department of Rehabilitation Sciences, Belgium , (Belgium)
  • 6 University Psychiatric Centre KU Leuven, Belgium , (Belgium)
  • 7 Federal University of Santa Maria, Brazil , (Brazil)
  • 8 University of ‐Cambridge, UK , (United Kingdom)
  • 9 University of York, UK , (United Kingdom)
  • 10 Harvard Medical School, USA , (United States)
  • 11 University of New South Wales, ‐Australia , (Australia)
  • 12 University College London, UK , (United Kingdom)
  • 13 Anglia Ruskin University, UK , (United Kingdom)
  • 14 Deakin University, Australia , (Australia)
  • 15 University of Palermo, Italy , (Italy)
  • 16 University of Toronto, Canada , (Canada)
  • 17 South London and Maudsley NHS Foundation Trust, UK , (United Kingdom)
  • 18 King's College London, UK , (United Kingdom)
  • 19 Metro South Addiction and Mental Health Service, Australia , (Australia)
  • 20 University of Queensland, Australia , (Australia)
  • 21 University of Melbourne, The Melbourne Clinic, Australia , (Australia)
  • 22 Centre for Addiction & Mental Health, Canada , (Canada)
Type
Published Article
Journal
World Psychiatry
Publisher
John Wiley & Sons, Inc.
Publication Date
Sep 15, 2020
Volume
19
Issue
3
Pages
360–380
Identifiers
DOI: 10.1002/wps.20773
PMID: 32931092
PMCID: PMC7491615
Source
PubMed Central
Keywords
License
Unknown
External links

Abstract

There 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.

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