A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders
Tóm tắt
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.
Từ khóa
Tài liệu tham khảo
Royal College of Psychiatrists. No health without public mental health: the case for action.https://www.rcpsych.ac.uk/pdf/PS04_2010.pdf.
Department of Health and Social Care. UK Chief Medical Officers' Physical Activity Guidelines.www.gov.uk/government/news/new‐physical‐activity‐guidelines.
Australian Department of Health. Australia's Physical Activity and Sedentary Behaviour Guidelines and the Australian 24‐Hour Movement Guidelines.www1.health.gov.au/internet/main/publishing.nsf/Content/health‐pubhlth‐strateg‐phys‐act‐guidelines.
Choi KW, 2019, A two‐stage approach to identifying and validating modifiable factors for the prevention of depression, bioRxiv, 759753
Wootton RE, Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: a Mendelian randomisation study, Psychol Med
Vermeulen JM, Smoking and the risk for bipolar disorder: evidence from a bidirectional Mendelian randomisation study, Br J Psychiatry
Treur J, 2020, Investigating causality between liability to ADHD and substance use, and liability to substance use and ADHD risk, using Mendelian randomization, Addict Biol, e12849
Nicolaou M, Association of a priori dietary patterns with depressive symptoms: a harmonised meta‐analysis of observational studies, Psychol Med
Kessler RC, 2007, Lifetime prevalence and age‐of‐onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative, World Psychiatry, 6, 168