LAUSR

455 includes studies on the impact of lifestyle behaviors on the prevalence of psychiatric symptoms or disorders in general populations, the impact of lifestyle behaviors on symptoms among people at risk for psychiatric disorders, the impact of lifestyle interventions on severity of symptoms among people with a psychiatric disorder, the neuroscience of brain response to lifestyle behaviors, and the science of lifestyle behavior change. The domains of lifestyle behaviors include physical exercise, diet and nutrition, meditation, mind-body practices, sleep, and social relationships. There is now an impressive body of literature on the neuroscience of physical exercise suggesting an upregulation of neurotransmitters associated with positive mood and neurotrophic factors that support neuronal vitality. Neurotrophins promote neoneurogenesis and synaptic proliferation associated with increases in regional brain volume and connectivity and enhanced cognitive function. Sustained exercise leads to epigenetic upregulation of brain-derived neurotrophic factor (BDNF) synthesis, promoting brain health over a lifetime. These regulatory interactions have been correlated with the evolutionary steps allowing early hominids to thrive in a hunter-gather lifestyle. There is a similarly impressive literature demonstrating robust brain functional and volumetric responses to meditation and sleep. We also know that lifestyle factors are powerfully correlated with the prevalence, onset and perpetuation of psychiatric symptoms and syndromes. Sedentary behavior has been correlated with risk for suicidal behavior, depression, cognitive decline of aging, and psychosis, while physical exercise has been correlated with improvements in mood, motivation and cognition. Sleeping less than 6 hours nightly is correlated with risk for major neurocognitive disorders. Mindfulness practices have been associated with improvements in anxiety and treatment-resistant depression. A Mediterranean style diet has been correlated with improvements in depression, and omega-3 fatty acids and N-acetylcysteine appear to have neuroprotective effects. However, our societies continue to shape human behavior in unhealthy directions. Sedentary time continues to rise in parallel to increases in substance abuse, suicide and emergency room visits for mental health care. Traditional diets are being progressively displaced by processed foods. Twenty-four hour virtual experiences constrain sleep opportunity, and social interaction is increasingly impersonal. Global health care systems are stressed by escalating rates of lifestyle-related disorders such as diabetes mellitus type 2, cardiovascular disease, cancer and psychiatric disorders. Lifestyle Psychiatry offers a unique opportunity for psychiatrists to join and lead other medical disciplines in promoting attention to the impact of lifestyle on health and disease. When clearly identified, the potential dual benefit for mental and physical health may enhance motivation to adhere to positive lifestyle changes. Psychiatrists also bring expertise in effective behavior change strategies. Lifestyle interventions may be useful for primary prevention, firstline therapy, multimodal therapy, augmentation, precision therapy and relapse prevention. There is an urgent need for psychiatry to step forward to assist governments, employers, corporations and health care systems to effectively position health-promoting lifestyle practices to address the rising tide of distress, disability and loss of life flowing from modern cultural trends in a global society. We must articulate the strength of the current evidence on the impact of lifestyle behaviors on mental and physical health outcomes, while identifying areas where further evidence is needed to offset the influences of globalization and corporate interest on human and societal health. The WPA Section on Medicine, Psychiatry and Primary Care aims to develop aware ness and expand consideration of Lifestyle Psychiatry as a vital component in improving the health and well-being of people around the world.