Yoga in Psychiatry: An Examination of Concept, Efficacy, and Safety

Effects of body-oriented yoga: a RCT study for patients with major depressive disorder

The major depressive disorder is one of the most common mental illnesses worldwide. Current treatment standards recommend a combined therapy with medication and psychotherapy. As an additive component and to further improvements in treatment, physical activity such as yoga may be integrated into conventional treatment. This study investigates the impact of a 3-month body-oriented yoga in patients with major depressive disorder (MDD). In total, n = 83 patients were included. An intervention group received a vigorous Ashtanga-Yoga three times a week. The waiting-list control group obtained a treatment as usual (TAU). As a primary outcome depression scores (Beck Depression Inventory-II (BDI-II), Montgomery Asberg Depression Rating Scale (MADRS)) were tested at three time points. Secondary outcome was the positive and negative affect [Positive and Negative Affect Scale (PANAS)] and remission rates. To analyze the data, multilevel models and effect sizes were conducted. The results showed an improvement in BDI-II scores for both groups over time [γ =  -  3.46, t(165) =  - 7.99, p < 0.001] but not between groups [γ = 0.98, t(164) = 1.12, p = 0.263]. An interaction effect (time x group) occurred for MADRS [γ = 2.10, t(164) = 2.10, p < 0.038]. Positive affects improved over time for both groups [γ = 1.65, t(165) = 4.03, p < 0.001]. Negative affects decreased for all over time [γ =  -  1.00, t(165) = - 2.51, p = 0.013]. There were no significant group differences in PANAS. Post hoc tests revealed a greater symptom reduction within the first 6 weeks for all measurements. The effect sizes for depression scores showed a positive trend. Remission rates indicated a significant improvement in the yoga group (BDI-II: 46.81%, MADRS: 17.02%) compared to the control group (BDI: 33.33%, MADRS: 8.33%). The findings suggest that there is a trendsetting additive effect of Ashtanga-Yoga after 3 months on psychopathology and mood with a greater improvement at the beginning of the intervention. Further research in this field can help to achieve more differentiated results.

Effectiveness of Rajyoga meditation as an adjunct to first-line treatment in patients with obsessive compulsive disorder

BACKGROUND

Yoga is a set of mental, physical, and spiritual practices with its origin in ancient India. The renewed interest in Yoga has led to the exploration of its benefits in a variety of psychiatric disorders such as schizophrenia, depression, and anxiety disorders. There is a dearth of literature on the effect of yoga in obsessive compulsive disorder (OCD) in the Indian context.

AIM

The present study was conducted to find out the efficacy of Rajyoga meditation (RM) as an adjunct to the first-line treatment in the treatment of OCD.

MATERIALS AND METHODS

Patients with OCD (diagnosed according to Diagnostic and Statistical Manual of Mental Disorders fifth edition) were divided into two groups - (i) The meditation group (MG), which included 28 patients and (ii) The nonmeditative group (NMG), which included 22 patients. MG practiced RM protocol for 3 months duration in addition to the pharmacological treatment. The NMG continued on pharmacological management as usual. The symptomatology was assessed at baseline and 3 months using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

RESULTS

At 3 months, both groups demonstrated improvement in symptoms. The improvement in MG was statistically significant with a change of 9.0 ± 3.16 in Y-BOCS and a 49.76 ± 9.52% reduction in symptoms. Improvement scores of NMG were also statistically significant with a change of 3.13 ± 2.59 in Y-BOCS and 18.09 ± 14.69% reduction in symptoms. MG showed significantly more improvement in Y-BOCS scores (49.76 ± 9.52) as compared to NMG (18.09 ± 14.69) using the student's paired t-test (P < 0.001).

CONCLUSION

The present study suggests that the RM is an effective adjunctive therapy to reduce obsessions and compulsions in patients with OCD.

Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials

Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0-38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = -0.43; 95% confidence interval [CI] = -0.74, -0.11; P = .008), and large effects compared to active comparators (SMD = -0.86; 95% CI = -1.56, -0.15; P = .02). Small effects on depression were found compared to no treatment (SMD = -0.35; 95% CI = -0.66, -0.04; P = .03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.

Immediate Effects of Yoga Breathing with Intermittent Breath Holding on Response Inhibition among Healthy Volunteers

Background:

There is very little evidence available on the effects of yoga-based breathing practices on response inhibition. The current study used stop-signal paradigm to assess the effects of yoga breathing with intermittent breath holding (YBH) on response inhibition among healthy volunteers.

Materials and Methods:

Thirty-six healthy volunteers (17 males + 19 females), with mean age of 20.31 ± 3.48 years from a university, were recruited in a within-subject repeated measures (RM) design. The recordings for stop signal task were performed on three different days for baseline, post-YBH, and post yogic breath awareness (YBA) sessions. Stop-signal reaction time (SSRT), mean reaction time to go stimuli (go RT), and the probability of responding on-stop signal trials (p [r/s]) were analyzed for 36 volunteers using RM analysis of variance.

Results:

SSRT reduced significantly in both YBH (218.33 ± 38.38) and YBA (213.15 ± 37.29) groups when compared to baseline (231.98 ± 29.54). No significant changes were observed in go RT and p (r/s). Further, the changes in SSRT were not significantly different among YBH and YBA groups.

Conclusion:

Both YBH and YBA groups were found to enhance response inhibition in the stop-signal paradigm. YBH could be further evaluated in clinical settings for conditions where response inhibition is altered.