Effects of Group Fitness Classes on Stress and Quality of Life of Medical Students.

CONTEXT: Medical school can produce intense psychological distress in its students; however, there is a paucity of research exploring potential means of improving medical students' well-being. OBJECTIVE: To investigate the relationship between physical exercise and stress and quality of life (QOL) in a medical student population. METHODS: This nonrandomized, controlled, 12-week study used a survey research design. First- and second-year osteopathic medical students at the University of New England College of Osteopathic Medicine were recruited to participate in 1 of 3 groups: (1) students participating in 30-minute CXWORX (Les Mills International LTD) group fitness classes; (2) students exercising alone or with up to 2 additional partners regularly (eg, running, weight lifting), henceforth called the health-enhancement group; and (3) students in a control group who did not engage in regular exercise. Participants completed the Perceived Stress Scale survey once every 4 weeks, as well as visual analog scale surveys to assess physical, mental, and emotional QOL weekly during the course of the study. Statistical significance was defined as P<.05. RESULTS: Sixty-nine participants met the inclusion criteria and completed the study protocol, with 25 in the fitness class group, 29 in the health-enhancement group, and 15 in the control group. Compared with baseline values, the fitness class group demonstrated decreased perceived stress (P=.038) and increased physical QOL (P=.007), mental QOL (P=.046), and emotional QOL (P=.004) after 12 weeks. Participants in the health-enhancement and control groups showed no statistically significant changes between baseline and week 12 for any of these parameters, with the exception of mental QOL, which improved in the health-enhancement group (P=.023). CONCLUSION: Participation in regular group fitness classes led to a statistically significant decrease in perceived stress and an increase in physical, mental, and emotional QOL compared with exercising regularly on one's own or not engaging in regular exercise. Attending weekly group fitness classes could be a solution to improving the emotional well-being and stress level of medical students.

Pharmacologic treatments for pediatric bipolar disorder: a review and meta-analysis.

OBJECTIVE: A growing body of literature has documented pediatric bipolar disorder to be a severely impairing form of psychopathology. However, concerns remain as to the inadequacy of the extant literature on its pharmacotherapy. Furthermore, treatment studies have not been systematically reviewed for treatment effects on core and associated symptoms. Thus, a systematic evaluation and synthesis of the available literature on the efficacy of antimanic pharmacotherapy for pediatric bipolar disorder on symptoms of mania, depression, and attention-deficit/hyperactivity disorder was undertaken. METHOD: A systematic search was conducted through PubMed from 1989 through 2010 for open-label and randomized controlled trials published in English on the pharmacotherapy of pediatric mania. RESULTS: There have been 46 open-label (n = 29) and randomized (n = 17) clinical trials of antimanic agents in pediatric bipolar disorder encompassing 2,666 subjects that evaluated a range of therapeutic agents, including traditional mood stabilizers, other anticonvulsants, second-generation antipsychotics, and naturopathic compounds. This literature has documented that the available armamentarium has different levels of efficacy in the treatment of pediatric mania. Because all psychotropic classes are associated with important adverse effects, a careful risk-benefit analysis is warranted when initiating pharmacologic treatment with any of these compounds. In the limited data available, the effects of antimanic agents on depression and symptoms of attention-deficit/hyperactivity disorder have been, in general, modest. Few studies have evaluated the effects of antimanic agents in children younger than 10 years. CONCLUSIONS: A substantial body of scientific literature has evaluated the safety and efficacy of various medicines and drug classes in the treatment of mania in pediatric bipolar disorder. More work is needed to assess the safety and efficacy of psychotropic drugs in children younger than 10 years, to further evaluate the efficacy of naturopathic compounds, and to further evaluate the effects of antimanic treatments for the management of depression and attention-deficit/hyperactivity disorder.