The Physical Activity Vital Sign and associations with cardiometabolic risks in people with bipolar disorder in a low-income country

Background: The mortality gap compared with the general population is with 29 years of potential life lost for people with bipolar disorder (BD) highest in Africa. The most significant contributor to premature mortality are preventable cardiovascular diseases due to an unhealthy lifestyle. This study investigated if the Physical Activity Vital Sign (PAVS), i.e. two questions which clarify if someone meets the recommended 150 min of physical activity (PA) per week, can identify patients with BD at higher risk of cardiometabolic abnormalities and mental health symptoms in a low-income country from Sub-Sahara Africa.Methods: 99 (54 female) Ugandan in-and outpatients (mean age = 34.5 +/- 9.4 years) with BD completed the PAVS and Brief Symptoms Inventory-18. Participants were screened for abdominal obesity (waist circumference > 90 cm), overweight (body mass index >= 25) and hypertension (systolic pressure >= 140 mmHg and/or diastolic pressure >= 90 mmHg).Results: 49.5 % (n = 49) met the PA recommendation. 43.4 % (n = 43) were overweight, 43.3 % (n = 43) had abdominal obesity and 20.2 % (n = 20) hypertension. Those who did not meet the PA recommendation were older (37.1 +/- 10.4 versus 32.2 +/- 7.7 years, p = 0.009), had a higher BSI-18 somatisation score (13.7 +/- 4.5 versus 10.4 +/- 4.2, p = 0.026), and a higher risk for overweight [relative risk (RR) = 2.99, 95 % confidence interval (CI) = 1.69-5.29], abdominal obesity (RR = 1.92, 95%CI = 1.19-3.09), and hypertension (RR = 2.23, 95%CI = 1.02-4.88).Conclusions: The PAVS might be an important risk identification tool in patients with BD in low-income countries such as Uganda. The low-cost and brevity of the PAVS may help promote the importance of PA assessment and prescription as a core part of the treatment of patients with BD in low-income settings.