Introduction: Major depressive disorder (MDD), generalized anxiety disorder (GAD), and bipolar disorder (BD) are mental illnesses associated with socio-cognitive functional impairments, reduced quality of life, and increased risk of medical and psychiatric comorbidities. These disorders are also associated with unhealthy patterns in several fundamental lifestyle areas according to the current notions of lifestyle psychiatry, such as diet, physical activity, substance use, sleep, stress management, and social relationships. With the rising prevalence rates of poor mental well-being following the onset of the COVID-19 pandemic, it is essential to understand the relationship between a multifactorial lifestyle and the presence of psychiatric symptoms. Thus, the aim of this thesis was to assess the association between a multidimensional lifestyle and symptoms of MDD and GAD during the COVID-19 pandemic, and lifestyle patterns among symptomatic individuals with BD. We additionally reviewed the literature on lifestyle interventions for improvement of outcomes related to BD.
Results: Unhealthy lifestyle behaviours were associated with symptoms of MDD and GAD during the COVID-19 pandemic in Spain, Brazil, and Canada. Machine learning analyses revealed strong predictive power for detecting the presence of these symptoms through lifestyle behaviours and perceptions. Individuals with BD engage in more unhealthy lifestyles than healthy individuals across all the core areas of lifestyle psychiatry, regardless of the polarity of the mood episode. Furthermore, to date, traditional lifestyle domains such as diet, physical activity, and sleep have been the most frequently targeted domains for interventions to improve mood symptoms and functional outcomes of BD, while domains such as substance use, stress management and social relationships have been more neglected. In addition, multidimensional lifestyle interventions have demonstrated a higher efficacy rate of improving outcomes of BD than single-domain interventions, however, there has been a lack of interventions for BD targeting majority of the core lifestyle domains.
Conclusion: The findings suggest that multidimensional unhealthy lifestyles are associated with symptoms of MDD, GAD, and BD. These results support the current notions of lifestyle psychiatry, indicating that a multidimensional assessment of lifestyle behaviours and perceptions can be a beneficial approach towards understanding the cumulative impact of various lifestyle patterns on psychiatric symptoms. This work highlights the importance of imposing a holistic approach towards studying the association between lifestyle factors and psychiatric disorders in order to implement effective, personalized preventive and treatment strategies for mental health disorders. / Thesis / Doctor of Philosophy (PhD) / People experiencing symptoms of psychiatric disorders may also engage in more unhealthy routines and behaviours in everyday life. Lifestyle is a construct characterized by behaviours and perceptions in multiple areas of life which are fundamental for the overall well-being of a person. The aim of this thesis was to investigate the relationship between multidimensional lifestyle characteristics and symptoms of depression, anxiety, and bipolar disorder (BD). We examined the association between multidimensional lifestyle and symptoms of depression and anxiety in the general populations of Spain, Brazil, and Canada during the COVID-19 pandemic. We also assessed the relationship between unhealthy behaviours and symptomatic individuals with BD in comparison to healthy individuals, and the importance of lifestyle interventions for improvement of outcomes related to BD. The findings indicated an association between multidimensional unhealthy lifestyles and symptoms of depression and anxiety during COVID-19. Unhealthy lifestyles across all domains were also seen in people with BD currently experiencing a mood episode, while lifestyle interventions for BD have shown promising results so far. A multidimensional approach to evaluating quality of lifestyle can be beneficial for developing preventive and treatment lifestyle strategies for common psychiatric disorders.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/28156 |
| Date | January 2022 |
| Creators | Simjanoski, Mario |
| Contributors | Kapczinski, Flavio, Neuroscience |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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