Malhi Gin S, Byrow Yulisha
Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.
Sydney Medical School Northern, University of Sydney, Sydney, New South Wales, Australia.
Evid Based Ment Health. 2016 Nov;19(4):103-105. doi: 10.1136/eb-2016-102430. Epub 2016 Sep 27.
Following extensive research exercise has emerged as an effective treatment for major depressive disorder, and it is now a recognised therapy alongside other interventions. In contrast, there is a paucity of research examining the therapeutic effects of exercise for those with bipolar disorder. Given that dysfunctional reward processing is central to bipolar disorder, research suggests that exercise can perhaps be framed as a reward-related event that may have the potential to precipitate a manic episode. The behavioural activation system (BAS) is a neurobehavioural system that is associated with responding to reward and provides an appropriate framework to theoretically examine and better understand the effects of exercise treatment on bipolar disorder. This article discusses recent research findings and provides an overview of the extant literature related to the neurobiological underpinnings of BAS and exercise as they relate to bipolar disorder. This is important clinically because depending on mood state in bipolar disorder, we postulate that exercise could be either beneficial or deleterious with positive or negative effects on the illness. Clearly, this complicates the evaluation of exercise as a potential treatment in terms of identifying its optimal characteristics in this population.
经过广泛研究，运动已成为治疗重度抑郁症的一种有效方法，目前它与其他干预措施一样，是一种公认的治疗方法。相比之下，针对双相情感障碍患者运动治疗效果的研究却很少。鉴于功能失调的奖赏处理是双相情感障碍的核心，研究表明，运动或许可以被视为一种与奖赏相关的事件，这可能会引发躁狂发作。行为激活系统（BAS）是一种神经行为系统，与对奖赏的反应相关，为从理论上研究和更好地理解运动治疗对双相情感障碍的影响提供了一个合适的框架。本文讨论了近期的研究结果，并概述了与BAS和运动的神经生物学基础相关的现有文献，这些文献与双相情感障碍有关。这在临床上很重要，因为根据双相情感障碍的情绪状态，我们推测运动可能有益也可能有害，对疾病有正面或负面的影响。显然，这使得在确定运动在该人群中的最佳特征方面，将其作为一种潜在治疗方法的评估变得复杂。
