1. IntroductionPatients with bipola

1. Introduction
Patients with bipolar disorder have higher levels of morbidity and mortality than the general population (De Hert et al., 2011). A recent meta-analysis (Walker et al., 2015) demonstrated that mortality rates are approximately two to three times higher than those of the general population. The underlying causes for the increased premature mortality are complex and multi-factorial (Hayes et al., 2015), but increased comorbid cardio-metabolic disease (Goldstein et al., 2015) is one of the most important risk factors. For example, compared with age- and gender matched general population groups, bipolar patients have a double increased risk for metabolic syndrome (odds ratio=1.98; 95% CI=1.74–2.25) (Vancampfort et al., 2013c) and diabetes (relative risk=1.98; 95% CI, 1.6–2.4) (Vancampfort et al., 2015b). Next to genetic predisposition (Ellingrod et al., 2012), shared pathophysiological mechanisms (Dargél et al., 2015), and side-effects of psychotropic medication (Vancampfort et al., 2015c), poor lifestyle habits including higher prevalence of smoking (Jackson et al., 2015) and substance abuse (Hjorthøj et al., 2015) and lower levels of physical activity (Janney et al., 2014) play prominent roles in the cardio-metabolic risk profile of people with bipolar disorder.
In addition to smoking cessation interventions (Mitchell et al., 2014), there is growing recognition of the importance of encouraging patients with bipolar disorder to sit less and move more as an essential, achievable strategy to improving health outcomes in this group (Vancampfort et al., 2015e). Although the evidence base for the mental health benefits of physical activity for patients with bipolar disorder is relatively limited in comparison to other mental disorders (Thomson et al., 2015), there is overwhelming evidence for the benefits of physical activity for improving physical health outcomes in the general population, with an established relationship between time spent being physically active, morbidity and mortality (Kodama et al., 2009). Nonetheless, despite progress in achieving mainstream recognition of the therapeutic benefits of integrating physical activity interventions as a routine component of treatment, physical activity remains an underutilized component of standard care (Vancampfort et al., 2015d). A comprehensive treatment plan for bipolar disorder should therefore consider physical activity as an essential medicine to decrease the risk of cardiovascular disease and address the premature mortality gap (Vancampfort et al., 2015d). An essential first step to promoting physical activity among bipolar disorder patients, is to ensure the routine assessment of physical activity, including time spent participating in structured exercise and incidental physical activity (Sallis, 2011). Without an understanding of current physical activity levels, it is difficult to advise patients on how to optimize their physical activity habits. The International Organization of Physical Therapists in Mental Health Guidelines for people with severe mental illness (Vancampfort et al., 2012) recommends that patients should achieve at least 150 min per week of moderate intensity (e.g., brisk walking) physical activity, or 75 min per week of vigorous physical activity (e.g., jogging). A major challenge to physical activity promotion in mental health care settings is time, specifically the competing demands in a typical 15–20 min office visit (De Hert et al., 2011). To date, there are currently no physical activity tools that quickly assess compliance with the international physical activity recommendations. Currently used questionnaires in clinical practice such as Baecke Physical Activity Questionnaire (Baecke et al., 1982) do not capture the time spent physically active at all while others such as the International Physical Activity Questionnaire (Craig et al., 2003) are intended for epidemiological research while its validity in clinical settings has been questioned (Rosenbaum and Ward, 2016 and Vancampfort et al., 2016b).
Given that physical activity participation has been shown to be a better predictor of morbidity in comparison to other traditional ‘vital signs’ such as blood pressure, the concept of incorporating physical activity as a vital sign for every patient has gained increasing clinical attention (Sallis, 2011). The physical activity vital sign (PAVS) is a two-question measure to assess the adherence to the international recommendation of 150 min per week of moderate to vigorous physical activity. To our knowledge, no study has considered whether using the PAVS-assessment can identify patients with bipolar disorder at greatest risk of cardio-metabolic disease (Greenwood et al., 2010). Given the aforementioned, the aim of the current study was to investigate if there are differences in cardio-metabolic risk factors (body mass index (BMI) overweight, abdominal obesity, hypertension, dyslipidemia, hyperglycemia and metabolic syn

ผลลัพธ์ (อังกฤษ) 2:

1. Introduction
Patients with Bipolar Disorder have Higher levels of morbidity and mortality than the general population (De Hert et al., 2011). A recent meta-analysis (Walker et al., 2015) demonstrated that mortality rates are approximately two to three times higher than those of the general population. The underlying causes for the increased premature mortality are complex and multi-factorial (Hayes et al., 2015), but increased comorbid cardio-metabolic disease (Goldstein et al., 2015) is one of the most important risk factors. For example, compared with age- and gender matched general population groups, bipolar patients have a double increased risk for metabolic syndrome (odds ratio = 1.98; 95% CI = 1.74-2.25) (Vancampfort et al., 2013c) and diabetes (relative. risk = 1.98; 95% CI, 1.6-2.4) (Vancampfort et al., 2015b). Next to genetic predisposition (Ellingrod et al., 2012), shared pathophysiological mechanisms (Dargél et al., 2015), and side-effects of psychotropic medication (Vancampfort et al., 2015c), poor lifestyle habits including higher prevalence of smoking (. Jackson et al., two thousand and fifteen) and substance abuse (Hjorthøj et al., in 2015) and Lower levels of physical Activity (Janney et al., 2,014) Play prominent roles in the Cardio-metabolic risk Profile of people with Bipolar Disorder.
in addition. to smoking cessation interventions (Mitchell et al., 2014), there is growing recognition of the importance of encouraging patients with bipolar disorder to sit less and move more as an essential, achievable strategy to improving health outcomes in this group (Vancampfort et al. , 2015e). Although the evidence base for the mental health benefits of physical activity for patients with bipolar disorder is relatively limited in comparison to other mental disorders (Thomson et al., 2015), there is overwhelming evidence for the benefits of physical activity for improving physical health outcomes. in the general population, with an established relationship between time spent being physically active, morbidity and mortality (Kodama et al., 2009). Nonetheless, despite progress in achieving mainstream recognition of the therapeutic benefits of integrating physical activity interventions as a routine component of treatment, physical activity remains an underutilized component of standard care (Vancampfort et al., 2015d). A comprehensive treatment plan for bipolar disorder should therefore consider physical activity as an essential medicine to decrease the risk of cardiovascular disease and address the premature mortality gap (Vancampfort et al., 2015d). An essential first step to promoting physical activity among bipolar disorder patients, is to ensure the routine assessment of physical activity, including time spent participating in structured exercise and incidental physical activity (Sallis, 2011). Without an understanding of current physical activity levels, it is difficult to advise patients on how to optimize their physical activity habits. The International Organization of Physical Therapists in Mental Health Guidelines for people with severe mental illness (Vancampfort et al., 2012) recommends that patients should achieve at least 150 min per week of moderate intensity (eg, brisk walking) physical activity, or 75 min. per week of vigorous physical activity (eg, jogging). A major challenge to physical activity promotion in mental health care settings is time, specifically the competing demands in a typical 15-20 min office visit (De Hert et al., 2011). To date, there are currently no physical activity tools that quickly assess compliance with the international physical activity recommendations. Currently used questionnaires in clinical practice such as Baecke Physical Activity Questionnaire (Baecke et al., 1982) do not capture the time spent physically active at all while others such as the International Physical Activity Questionnaire (Craig et al., 2003) are intended for. epidemiological Research while ITS validity in clinical settings has been questioned (Rosenbaum and Ward, 2016th and Vancampfort et al., 2016b).
Given that physical Activity Participation has been shown to be a better predictor of morbidity in comparison to Other Traditional 'Vital Signs'. such as blood pressure, the concept of incorporating physical activity as a vital sign for every patient has gained increasing clinical attention (Sallis, 2011). The physical activity vital sign (PAVS) is a two-question measure to assess the adherence to the international recommendation of 150 min per week of moderate to vigorous physical activity. To our knowledge, no study has considered whether using the PAVS-assessment can identify patients with bipolar disorder at greatest risk of cardio-metabolic disease (Greenwood et al., 2010). Given the aforementioned, the aim of the current study was to investigate if there are differences in cardio-metabolic risk factors (body mass index (BMI) overweight, abdominal obesity, hypertension, dyslipidemia, hyperglycemia and metabolic syn.

ผลลัพธ์ (อังกฤษ) 3:

1. Introduction.Patients with bipolar disorder have higher levels of morbidity and mortality than the general population (De Hert et al.,. 2011). A recent meta-analysis (Walker et al, 2015) demonstrated that mortality rates are approximately two to three times. Higher than those of the general population. The underlying causes for the increased premature mortality are complex and. Multi-factorial (Hayes et al, 2015), but increased comorbid cardio-metabolic disease (Goldstein et al, 2015) is one of. The most important risk factors. For example compared with, age - and gender matched general population groups bipolar patients,, Have a double increased risk for metabolic syndrome (odds ratio = 1.98; 95% CI = 1.74 - 2.25) (Vancampfort et al, 2013c and.) Diabetes (relative risk = 1.98; 95%, CI 1.6 - 2.4) (Vancampfort et al, 2015b). Next to genetic predisposition (Ellingrod et. Al, 2012), shared pathophysiological mechanisms (Darg é l et al, 2015), and side-effects of psychotropic medication (Vancampfort. Et al, 2015c), poor lifestyle habits including higher prevalence of smoking (Jackson et al, 2015) and substance abuse. (Hjorth ø j et al, 2015) and lower levels of physical activity (Janney et al, 2014) play prominent roles in the cardio-metabolic. Risk profile of people with bipolar disorder.In addition to smoking cessation interventions (Mitchell et al, 2014), there is growing recognition of the importance. Of encouraging patients with bipolar disorder to sit less and move more as, an essential achievable strategy to improving. Health outcomes in this group (Vancampfort et al, 2015e). Although the evidence base for the mental health benefits of. Physical activity for patients with bipolar disorder is relatively limited in comparison to other mental disorders (Thomson. Et al, 2015), there is overwhelming evidence for the benefits of physical activity for improving physical health outcomes. In the general population with an, established relationship between time spent being, physically active morbidity and mortality. (Kodama et al, 2009). Nonetheless despite progress, in achieving mainstream recognition of the therapeutic benefits of. Integrating physical activity interventions as a routine component of treatment physical activity, remains an underutilized. Component of standard care (Vancampfort et al, 2015d). A comprehensive treatment plan for bipolar disorder should therefore. Consider physical activity as an essential medicine to decrease the risk of cardiovascular disease and address the premature. Mortality gap (Vancampfort et al, 2015d). An essential first step to promoting physical activity among bipolar disorder. Patients is to, ensure the routine assessment of physical activity including time, spent participating in structured exercise. And incidental physical, activity (Sallis 2011). Without an understanding of current physical activity levels it is, difficult. To advise patients on how to optimize their physical activity habits. The International Organization of Physical Therapists. In Mental Health Guidelines for people with severe mental illness (Vancampfort et al, 2012) recommends that patients should. Achieve at least 150) min per week of moderate intensity (e.g, brisk walking), physical activity or 75 min per week of vigorous. " Physical activity (e.g, jogging). A major challenge to physical activity promotion in mental health care settings, is time. Specifically the competing demands in a typical 15 - 20) min office visit (De Hert et al, 2011). To date there are, currently. No physical activity tools that quickly assess compliance with the international physical activity recommendations. Currently. Used questionnaires in clinical practice such as Baecke Physical Activity Questionnaire (Baecke et al, 1982) do not capture. The time spent physically active at all while others such as the International Physical Activity Questionnaire (Craig et. Al, 2003) are intended for epidemiological research while its validity in clinical settings has been questioned (Rosenbaum. And Ward 2016), and) Vancampfort et al, 2016b).Given that physical activity participation has been shown to be a better predictor of morbidity in comparison to other. Traditional "vital signs" such as blood pressure the concept, of incorporating physical activity as a vital sign for every. Patient has gained increasing clinical, attention (Sallis 2011). The physical activity vital sign (PAVS) is a two-question. Measure to assess the adherence to the international recommendation of 150) min per week of moderate to vigorous physical. Activity. To our knowledge no study, has considered whether using the PAVS-assessment can identify patients with bipolar. Disorder at greatest risk of cardio-metabolic disease (Greenwood et al, 2010). Given the aforementioned the aim, of the. Current study was to investigate if there are differences in cardio-metabolic risk factors (body mass index (BMI), overweight. ,,, abdominal obesity hypertension dyslipidemia hyperglycemia and met.