The importance of psychiatry and behavioral health in the delivery of overall health care and optimization of health is widely acknowledged. However, the stigma related to mental illness in society and the separation of psychiatric care from tra­ditional medical settings has resulted in significant challenges in integrating all aspects of care necessary in maintaining op­timal health and well-being.

The sub-specialty of consultation/liaison psychiatry has attempted to address this issue in the inpatient medical setting by providing psychiatric consultation to medical patients experiencing psychiatric symptoms and syndromes. Unfortunately, we have been less effective in creating integrated models of care, especially in the outpatient setting. Compounding this problem is the lack of psychiatrists internation­ally, with very few formally trained in integrated care models.

The COVID-19 pandemic has produced unprecedented challenges, while generating unique opportunities for education and novel clinical care models. The need for interdisciplinary collaborative models of care, integrating public health, public policy and public education, in concert with mental health and primary care provision, has never been so significant.

The WPA Section on Medicine, Psychia­try and Primary Care has restructured to ad­dress these issues, with a focus on expand­ing collaboration with other WPA Scientific Sections and by reaching out to interprofessional colleagues and health care professional organizations. The Section leadership has created projects to focus on var­ious aspects of this new strategy. One of these is the Lifestyle Psychiatry project. We see this as a true opportunity for collaboration between many WPA Scientific Sections with related interests, along with non-psychiatric stakeholders. The WPA leadership has endorsed the concept and is supporting the growth of this model. Any WPA member or Section Chair is warmly invited to contact our Section to discuss additional collaborations.

Lifestyle psychiatry refers to the application of lifestyle medicine principles to support individuals in managing psychiatric disorders and cultivating brain health¹. It 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 change². The domains of lifestyle behaviors include physical exercise, diet and nutrition, meditation, mind-body practices, sleep, and social relationships^{1, 2}.

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 neo-neurogenesis and synaptic proliferation associated with increases in regional brain volume and connectivity and enhanced co­gnitive function³. Sustained exercise leads to epigenetic upregulation of brain-derived neurotrophic factor (BDNF) synthesis, promoting brain health over a lifetime⁴. These regulatory interactions have been correlated with the evolutionary steps allowing early hominids to thrive in a hunter-gather lifestyle⁵. There is a similarly impressive literature demonstrating robust brain functional and volumetric responses to meditation and sleep⁶.

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 cognition⁷. 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 effects⁸.

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 impersonal⁹. 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, first-line 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 aware­ness and expand consideration of Lifestyle Psychiatry as a vital component in improving the health and well-being of people around the world.

精神病学和行为健康在提供整体医疗保健和优化健康方面的重要性已得到广泛承认。然而，社会上与精神疾病相关的污名化以及精神科护理与传统医疗环境的分离，给整合维持最佳健康和福祉所需的所有护理方面带来了重大挑战。

咨询/联络精神病学子专业试图通过向出现精神病症状和综合征的医疗患者提供精神病咨询来解决住院医疗环境中的这个问题。不幸的是，我们在创建综合护理模式方面效率较低，尤其是在门诊环境中。使这个问题更加复杂的是国际上缺乏精神科医生，很少有人接受过综合护理模式的正式培训。

COVID-19 大流行带来了前所未有的挑战，同时为教育和新型临床护理模式创造了独特的机会。整合公共卫生、公共政策和公共教育以及心理健康和初级保健提供的跨学科协作护理模式的需求从未如此重要。

WPA 医学、精神病学和初级保健部门已进行重组以解决这些问题，重点是扩大与其他 WPA 科学部门的合作，并与跨专业的同事和医疗保健专业组织进行接触。科领导创建了一些项目，以关注这一新战略的各个方面。其中之一是生活方式精神病学项目。我们认为这是许多具有相关利益的 WPA 科学部门与非精神病利益相关者之间合作的真正机会。WPA 领导层认可了这一概念，并正在支持这种模式的发展。任何 WPA 成员或分会主席都被热烈邀请与我们的分会联系以讨论其他合作。

生活方式精神病学是指应用生活方式医学原理来支持个人管理精神疾病和培养大脑健康¹。它包括关于生活方式行为对一般人群精神症状或障碍患病率的影响、生活方式行为对有精神障碍风险人群症状的影响、生活方式干预对精神障碍患者症状严重程度的影响的研究。障碍，大脑对生活方式行为反应的神经科学，以及生活方式行为改变的科学²。生活方式行为的领域包括体育锻炼、饮食和营养、冥想、身心练习、睡眠和社会关系^{1, 2}。

现在有大量关于体育锻炼的神经科学的文献表明，与积极情绪和支持神经元活力的神经营养因子相关的神经递质上调。神经营养因子促进新神经发生和突触增殖，与区域脑容量和连通性的增加以及增强的认知功能^{3 相关}。持续运动导致脑源性神经营养因子 (BDNF) 合成的表观遗传上调，促进终生的大脑健康⁴。这些调节相互作用与允许早期原始人在狩猎采集生活方式中茁壮成长的进化步骤相关联⁵. 有类似令人印象深刻的文献展示了对冥想和睡眠^{6 的}强大大脑功能和体积反应。

我们还知道，生活方式因素与精神症状和综合征的流行、发作和持续存在密切相关。久坐行为与自杀行为、抑郁、衰老认知能力下降和精神病的风险相关，而体育锻炼与情绪、动机和认知的改善相关⁷。每晚睡眠少于 6 小时与主要神经认知障碍的风险相关。正念练习与焦虑和难治性抑郁症的改善有关。地中海式饮食与抑郁症的改善有关，omega-3 脂肪酸和 N-乙酰半胱氨酸似乎具有神经保护作用⁸。

然而，我们的社会继续在不健康的方向上塑造人类行为。久坐时间继续增加，同时药物滥用、自杀和精神卫生保健急诊室就诊的增加。传统饮食正逐渐被加工食品所取代。24 小时的虚拟体验限制了睡眠机会，社交互动越来越没有人情味⁹。与生活方式相关的疾病（例如 2 型糖尿病、心血管疾病、癌症和精神疾病）的发病率不断上升，给全球卫生保健系统带来了压力。

生活方式精神病学为精神科医生提供了一个独特的机会，可以加入并领导其他医学学科，以促进人们对生活方式对健康和疾病的影响的关注。如果明确确定，心理和身体健康的潜在双重益处可能会增强坚持积极生活方式改变的动力。精神科医生还带来了有效的行为改变策略方面的专业知识。生活方式干预可能对初级预防、一线治疗、多模式治疗、增强治疗、精准治疗和复发预防有用。

精神病学迫切需要挺身而出，协助政府、雇主、公司和医疗保健系统有效地定位促进健康的生活方式，以应对全球现代文化趋势带来的日益严重的痛苦、残疾和生命损失。社会。

我们必须阐明当前关于生活方式行为对身心健康结果影响的证据的强度，同时确定需要进一步证据的领域，以抵消全球化和企业利益对人类和社会健康的影响。

WPA 医学、精神病学和初级保健科旨在提高人们对生活方式精神病学的认识并扩大对生活方式的考虑，将其视为改善世界各地人们健康和福祉的重要组成部分。