The association between self-reported physical activity and objective measures of physical activity in participants with newly diagnosed bipolar disorder, unaffected relatives, and healthy individuals

Abstract

Background

The association between the International Physical Activity Questionnaire Short Form (IPAQ-SF) and objective measures of physical activity has never been evaluated in participants with newly diagnosed bipolar disorder (BD). Our aim was to compare IPAQ-SF to objective measures in participants with newly diagnosed BD, their unaffected first-degree relatives (UR), and healthy control individuals (HC) in groups combined and stratified by group.

Materials and methods

Physical activity measurements were collected on 20 participants with newly diagnosed BD, 20 of their UR, and 20 HC using individually calibrated combined acceleration and heart rate sensing (Actiheart) for seven days. IPAQ-SF was self-completed at baseline. Correlation between measurements from the two methods was examined with Spearman rank correlation coefficient and agreement levels examined with modified Bland–Altman plots.

Results

Physical activity energy expenditure (PAEE) from IPAQ-SF was weakly but significantly positively correlated with physical activity estimates measured using acceleration and heart rate in groups combined (Actiheart PAEE) (ρ= 0.301, p = 0.02). Correlations for each group were positive, but only in UR were it statistically significant (BD: p = 0.18, UR: p = 0.007, HC: p = 0.84). Self-reported PAEE and moderate-intensity were markedly underestimated [PAEE in all participants combined: 62.7 (Actiheart) vs. 24.3 kJ/day/kg (IPAQ-SF), p < 0.001], while vigorous-intensity was overestimated. Bland–Altman plots indicated proportional bias.

Conclusion

These results suggest that the use of the IPAQ-SF to monitor levels of physical activity in participants with newly diagnosed BD, in a psychiatric clinical setting, should be used with caution and consideration.

Keywords:

• Bipolar disorder
• physical activity
• IPAQ
• physical activity energy expenditure
• unaffected relatives

Acknowledgments

The authors are very thankful to all the participants for volunteering their time to our project.

Author contributions

MFJ and LVK have designed the study. MFJ has drafted the study protocol and supervised the project. JF has collected the data, conducted the statistical analyses and written the original draft of the manuscript. SB, LVK and MFJ have reviewed and edited the manuscript. All authors have seen and approved the final version of the manuscript being submitted.

JF: MD, Resident Doctor currently working in Region South Denmark in Family Medicine. SB: Leader of the physical activity epidemiology program in the MRC Epidemiology Unit, University of Cambridge and Adjunct Professor at the University of South Denmark. MFJ: MD, Post Doc Researcher and Resident Doctor at Psychiatric Center Copenhagen, Rigshospitalet. LVK: MD, Professor and Chief Physician at Psychiatric Center Copenhagen, Rigshospitalet.

Disclosure statement

JF, SB and MFJ declare no conflicts of interest. LVK has within recent three years been a consultant for Lundbeck.

Additional information

Funding

The BIO-study, of which this is a sub-study, is funded by grants from the Mental Health Services, Capital Region of Denmark, The Danish Council for Independent Research, Medical Sciences [DFF-4183-00570], Weimans Fund, Markedsmodningsfonden [the Market Development Fund 2015-310], Gangstedfonden [A29594], Helsefonden [16-B-0063], Innovation Fund Denmark [the Innovation Fund, Denmark, 5164-00001B], Copenhagen Center for Health Technology (CACHET), EU H2020 ITN [EU project 722561], Augustinusfonden [16-0083], Lundbeck Foundation [R215-2015-4121]. The work of SB was supported by the Medical Research Council [grant number MC_UU_12015/3] and the National Institute of Health Research Cambridge (NIHR) Biomedical Research Centre [grant number IS-BRC-1215-20014].