ArticleLiterature Review

# Yoga for depression: A systematic review and meta-analysis

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## Abstract

Mind-body medical interventions are commonly used to cope with depression and yoga is one of the most commonly used mind-body interventions. The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga for depression. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through January 2013. Randomized controlled trials (RCTs) of yoga for patients with depressive disorders and individuals with elevated levels of depression were included. Main outcomes were severity of depression and remission rates, secondary outcomes were anxiety, quality of life, and safety. Twelve RCTs with 619 participants were included. Three RCTs had low risk of bias. Regarding severity of depression, there was moderate evidence for short-term effects of yoga compared to usual care (standardized mean difference (SMD) = -0.69; 95% confidence interval (CI) -0.99, -0.39; P < .001), and limited evidence compared to relaxation (SMD = -0.62; 95%CI -1.03, -0.22; P = .003), and aerobic exercise (SMD = -0.59; 95% CI -0.99, -0.18; P = .004). Limited evidence was found for short-term effects of yoga on anxiety compared to relaxation (SMD = -0.79; 95% CI -1.3, -0.26; P = .004). Subgroup analyses revealed evidence for effects in patients with depressive disorders and in individuals with elevated levels of depression. Due to the paucity and heterogeneity of the RCTs, no meta-analyses on long-term effects were possible. No RCT reported safety data. Despite methodological drawbacks of the included studies, yoga could be considered an ancillary treatment option for patients with depressive disorders and individuals with elevated levels of depression.

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... Yoga interventions have been infrequently studied among those with ADHD (Jensen and Kenny, 2004;Peck et al., 2005). Results from studies investigating the effects of yoga training in adults without ADHD have found both physical and mental health benefits (Cramer et al., 2013(Cramer et al., , 2014Gothe, 2015), such as improvements in anxiety, cognition, and increased mindfulness (Hewett et al., 2011;Cramer et al., 2013;Gothe, 2015). Mindfulness meditation, in the absence of yoga, has been shown to activate the brain (Chambers et al., 2009;Hölzel et al., 2011;Lomas et al., 2015) and improve several psychological outcomes, especially stress and anxiety (Hofmann et al., 2010). ...
... Yoga interventions have been infrequently studied among those with ADHD (Jensen and Kenny, 2004;Peck et al., 2005). Results from studies investigating the effects of yoga training in adults without ADHD have found both physical and mental health benefits (Cramer et al., 2013(Cramer et al., , 2014Gothe, 2015), such as improvements in anxiety, cognition, and increased mindfulness (Hewett et al., 2011;Cramer et al., 2013;Gothe, 2015). Mindfulness meditation, in the absence of yoga, has been shown to activate the brain (Chambers et al., 2009;Hölzel et al., 2011;Lomas et al., 2015) and improve several psychological outcomes, especially stress and anxiety (Hofmann et al., 2010). ...
... It was unexpected that trait anxiety and mood states were not significantly changed in the yoga group given the benefits for anxiety and depression reported in other yoga studies (Woolery et al., 2004;Cramer et al., 2013). A previous study investigating the effects of twice weekly Iyengar yoga reported significant decreases in both trait anxiety and depression for yoga participants after five weeks when compared to wait-list control group (Woolery et al., 2004). ...
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... Meanwhile, research in clinical settings also suggests that there is a large potential for yoga to help individuals with the lowest levels of well-being. For instance, a meta-analysis investigating the effects of yoga on depression has shown that the most depressed individuals gain the most benefits from practising yoga (Cramer et al., 2013). Another empirical study has also demonstrated that hot yoga is particularly effective in reducing negative-affect and state-anxiety in individuals who are under substantial stress in daily life (Szabo et al., 2017). ...
... Our results suggested this might be the case, as hot yoga participants with lower levels of flourishing, mental well-being, and eudaimonic well-being at the T1 stage (i.e., before starting classes) experienced a stronger boost in positive emotion during the six-week intervention. Our research has added valuable experience-sampling data to a group of studies that document people with lower levels of well-being, such as those who are depressed and stressed, gaining the most from practising yoga (e.g., Cramer et al., 2013;Szabo et al., 2017). Coupled with previous empirical evidence, our findings may provide insights into not only PPIs, but also the allocation of social resources to people most at risk of mental problems. ...
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Practicing hot yoga may bring significant psychological benefits, but it is largely unstudied. We examined the effectsof hot yoga on multifaceted well-being indicators with 290 healthy yoga-naïve volunteers partaking in a six-weekrandomized controlled trial. Participants completed questionnaires pre- and post-intervention, and reported theiremotional experiences four times per day throughout an experience-sampling study. Results revealed that the hot yogagroup (n = 137) improved their well-being from pre- to post-treatment, comparing to the wait-list control group (n = 153).These improvements included life satisfaction, general health, mindfulness, peace of mind, and eudaimonic well-being(ΔR2 ranging from .01 to .08)—but not flourishing, which describes major aspects of social-psychological functioning.Multilevel analyses demonstrated that momentary positive emotional experiences increased significantly throughoutthe trial in the yoga group only (conditional R2 = .68), particularly when attending a yoga class (conditional R2 = .50).Interestingly, this increase in momentary positive emotion explained the improvement in post-intervention mindfulness,peace of mind, and general health by 21%, 31%, and 11%, respectively. Finally, the benefits of hot yoga were more notablein individuals with lower levels of baseline eudaimonic well-being (conditional R2 = .45), flourishing (conditional R2= .61), and mental well-being (conditional R2 = .65), even after ruling out any possible ceiling effects. To sum up, thisstudy demonstrated multiple psychological benefits of hot yoga and its potential to be an effective positive psychologyintervention. Future research—especially considering an active control group—is warranted.
... Traditional yoga includes ethical lifestyle, spiritual practice, physical activity, breathing exercises, and meditation. The ultimate goal of traditional yoga is to unite mind, body, and spirit, and for this reason it has become a popular means of promoting physical and mental well-being [13]. Even though yoga is based on exercises, this intervention differs from purely gymnastic exercises, as the yoga practitioner focuses his mind on postures with inner awareness and a meditative focus of the mind [14,15]. ...
... There are five traditional forms of yoga: gyan yoga, karma yoga, bhakti yoga, raja yoga, and hatha yoga. Yoga is effective for treating anxiety, depression, and psychological distress, and also has a positive effect on stress reduction in healthy adults [11,13,16]. ...
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The practice of meditation today has an objective to test the malleability of the brain based on neuroplasticity. Science is discovering the physiological and psychological benefits of meditation, since it is fundamental to consider all aspects that influence health. Among a large number of meditation techniques currently used, this chapter focuses on the benefits of practicing mindfulness and yoga used in addition to medicine and psychology resources for patients undergoing assisted human reproduction. Growing knowledge about psychological implications of infertility demonstrates that medical and psychological factors cannot be separated, both in terms of diagnosis and treatment. Assisted reproductive techniques and infertility treatments are multidimensional stressors. Fertility problems are accompanied by much emotional distress, and infertile women have higher levels of anxiety and depression than normal. In addition, mood disorders are common in both women and men undergoing in vitro fertilization procedures. This chapter will present studies which show that mindfulness and yoga could be helpful for people suffering from infertility, undergoing in vitro fertilization, or even improving semen quality.
... O yoga mostrou efeitos moderados em curto prazo para a gravidade da depressão nos subgrupos de casos diagnos-ticados pelo Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-IV) ou de comparação com exercícios aeróbicos; já no longo prazo não houve diferença (12 ECR com 452 participantes, incluídos em uma RS com grau baixo de qualidade). 20 Em uma RS com baixo grau de qualidade, os resultados foram inconsistentes em quatro estudos primários que mediram os efeitos da Laughter yoga na depressão: houve melhora entre mulheres idosas deprimidas e redução do humor deprimido entre homens universitários em medidas imediatamente após e um mês depois da intervenção. Todavia, dois estudos primários não encontraram mudanças logo após a intervenção. ...
... 37 Uma revisão sistemática com grau baixo de qualidade não encontrou efeitos no curto prazo para o uso de yoga para ansiedade em comparação ao tratamento habitual e evidências limitadas foram encontradas favoráveis ao yoga em relação ao relaxamento. 20 Em uma revisão sistemática com grau criticamente baixo de qualidade, que incluiu 23 estudos (sendo nove ECR) com 39 a 131 participantes, os resultados foram mistos. 38 Dois estudos não apresentaram resultados significativos e nos demais estudos o yoga foi apontado como efetivo. ...
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... The beneficial effects of yoga on hypertension may occur through its blood pressure-lowering effect (11), as well as its effects on physical activity, stress reduction, and lifestyle (16)(17)(18)(19). The exact mechanism of yoga for lowering blood pressure is not known yet but proposed physiological mechanisms include an increase in parasympathetic activity, possibly due to vagal stimulation, the suppression of the hypothalamic-pituitaryadrenal axis, and reduction in the activity and reactivity of the sympathetic nervous system (20)(21)(22)(23). ...
... 2020 ISH Global Hypertension Practice Guidelines also suggest yoga as an aerobic form of physical activity under lifestyle modification (8). Yoga has been shown to improve stress levels (18,25), which is associated with high blood pressure (8). In addition, yoga focuses on a healthier and mindful lifestyle, which supports people for a healthier diet, and abstinence from smoking and alcohol (26)(27)(28). ...
Article
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Objectives: This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions used for managing hypertension and to compare these characteristics with ineffective interventions. Design and Method: The JBI and the PRISMA guidelines were followed in this systematic review. RCTs conducted among hypertensive adults were included. RCTs reporting at least one of the major components of yoga (i.e., asana, pranayama, and dhyana and relaxation practices) and comparing them with no intervention or any intervention were eligible. Sixteen databases were searched for published and unpublished studies without any date and language restrictions till March 15, 2021. Results: The literature search yielded 13,130 records. 34 RCTs (evaluating 38 yoga interventions) met the inclusion criteria. Overall, included studies had low methodological quality mostly due to inadequate reporting. Yoga reduced SBP and DBP compared to a control intervention (MD −6.49 and −2.78; 95CI% −8.94-−4.04 and −4.11-−1.45, respectively). Eighteen, 14 and 20 interventions were effective in improving SBP, DBP, or either, respectively. 13 out of 20 effective interventions incorporated all the 3 major components of yoga and allocated similar durations to each component whereas ineffective interventions were more focused on the asana and duration of asana practice was longer. The most common duration and frequency of effective interventions were 45 min/session (in 5 interventions), 7 days/week (in 5 interventions), and 12 weeks (in 11 interventions) whereas the most common session frequency was 2 days a week (in 7 interventions) in ineffective interventions. Effective interventions were mostly center-based (in 15 interventions) and supervised (in 16 interventions) and this was similar with ineffective interventions. Conclusion: Despite the low quality and heterogeneity of included studies, our findings suggest yoga interventions may effectively manage hypertension. The differences between the effective and ineffective interventions suggest that effective yoga interventions for managing hypertension yoga interventions mostly incorporated asana, pranayama, and dhyana and relaxation practices and they had a balance between these three components and included regular practice. They were mostly delivered in a center and under supervision. Future studies should consider developing and evaluating an intervention for managing hypertension using the synthesized findings of the effective interventions in this review. Systematic Review Registration: [PROSPERO], identifier [CRD42019139404].
... In addition, pranayama itself effectively reduces stress [49,50]; V. K [51]. Accordingly, the therapeutic effect of pranayama-based yoga forms is more evident than that of other yoga styles [52]. Consequently, pranayama practice might be more closely related to the REA based on both Interactional-and Four-Phase Models [25,26]. ...
... Furthermore, the study aimed to test the relationship between the REA and passion. Finally, based on the beneficial health effects of pranayama practice reported in the literature [52], this research also sought to test the differences in passion and addiction between regular pranayama practitioners and those who seldom or never used pranayama in their yoga practice. ...
Article
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Yoga is a popular leisure activity and health practice worldwide, especially among women. It could become a long-term lifestyle involving passion, but, like other exercises, it may become addictive. While exercise addiction is widely studied, addiction to yoga remains unexplored. In this cross-sectional study, we examined 215 highly experienced women who practiced yoga for at least three years and at least twice weekly. We scrutinized harmonious passion (HP), obsessive passion (OP), risk of exercise addiction (REA), and various yoga-related measures. Only 2/215 (0.93%) of the sample were at REA. Reported HP, OP, feeling guilty when missing a yoga session, and the tendency to practice yoga when injured predicted the REA by accounting for 42% of the variance. Yogis who regularly practiced pranayama (breathing exercises) scored higher on HP, weekly yoga practice, and posting messages on social media than those who never or seldom used breath regulation. Participants choose yoga primarily for health and social reasons. The posting of yoga-related messages on social media was positively related to HP, OP, REA, and frequency of practice. The conclusions of this study are 1) the REA among experienced female yogis is negligible, 2) HP is higher in yoga forms that involve pranayama, 3) yoga practice is primarily related to health and social factors, and 4) a more intense passion for yoga is related to more frequent social media activities.
... Yoga, therefore, may represent a more accessible form of mindfulness practice than seated and concentration practices of meditation (Carmody & Baer, 2008;Dick et al., 2014). In parallel, yoga has demonstrated emerging evidence as a treatment for anxiety (Cramer et al., 2018) and depression (Cramer et al., 2017;Cramer et al., 2013), but the pilot nature of this evidence has hampered establishing definitive conclusions about the efficacy of yoga for these conditions as a standalone treatment. ...
... power of 80%, and a correlation parameter of .8, following previous research (Cramer et al., 2013), a total sample size of 56 participants was needed to detect a minimum absolute effect size of f = 0.4. ...
Article
Background Yoga has several mechanisms that make it a promising treatment for depression and anxiety, including physical activity, behavioural activation, and mindfulness. Following positive outcomes from adapted CBT interventions incorporating mindfulness-based practices, this study explored the effects of a therapeutic yoga program as an adjunct to group-based CBT for depression or anxiety. Methods This was a pragmatic preference trial involving adults diagnosed with depression or anxiety in a regional primary mental healthcare service (n = 59), comparing transdiagnostic group CBT (n = 27) with transdiagnostic group CBT combined with an adjunct therapeutic yoga program (n = 32). A preference recruitment design allowed eligible participants (n = 35) to self-select into the adjunct program. The Depression Anxiety Stress Scale-21 (DASS) was assessed at baseline, post-intervention, and three-months follow up. Results CBT + Yoga was an acceptable alternative to CBT alone. Significant reductions were observed in total DASS scores and the 3 subscales of the DASS for both groups, however CBT + Yoga showed significantly lower depressive and anxiety symptoms post-intervention, compared to CBT alone. CBT + Yoga also showed sustained reductions in depressive symptoms over three-months, and more rapid reductions in depressive symptoms, compared to CBT alone. Limitations These findings should be considered preliminary due to the moderate sample size, with a rigorous randomised control trial necessary to definitively support the integration of yoga within mental health care to augment the benefits and uptake of transdiagnostic CBT for depression and anxiety. Conclusions Complementing other mindfulness-based practices, therapeutic yoga shows promise as an adjunct to transdiagnostic CBT.
... In a meta-analysis by Cramer et al., yoga was found to be an effective intervention for improving depression [68]. Multiple studies have confirmed that yoga practice reduced depression and improved mood and cognitive function among patients with mild to moderate depression. ...
... Multiple studies have confirmed that yoga practice reduced depression and improved mood and cognitive function among patients with mild to moderate depression. This is achieved by enhancing the HPA axis function, increasing brain-derived neurotrophic factor (BDNF) levels and serotonin levels, and decreasing cortisol and inflammatory markers [68,74,75]. Autonomic dysfunction is a hallmark of both anxiety and depression [76]; regular yoga practice of pranayama can help improve autonomic balance by decreasing sympathetic overactivity and improving parasympathetic activity [69]. ...
Article
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A narrative review on yoga: a potential intervention for augmenting immunomodulation and mental health in COVID-19 | BMC Complementary Medicine and Therapies | Full Text (biomedcentral.com) https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-022-03666-2
... Yoga has been found to have robust effects on poor mental wellbeing -notably, by decreasing anxiety and depression [21,22], as well as physiological markers of stress, such as blood pressure, heart rate, and cortisol [11,23]. For example, a meta-analysis of 12 randomised control trials of yoga interventions for patients with depressive disorders and elevated levels of depression found reductions in severity of depression compared to receiving standard care only [21]. ...
... Yoga has been found to have robust effects on poor mental wellbeing -notably, by decreasing anxiety and depression [21,22], as well as physiological markers of stress, such as blood pressure, heart rate, and cortisol [11,23]. For example, a meta-analysis of 12 randomised control trials of yoga interventions for patients with depressive disorders and elevated levels of depression found reductions in severity of depression compared to receiving standard care only [21]. Yoga interventions have also been shown to reduce perceived levels of stress both in healthy adults and ageing populations [24,25]. ...
Article
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Background Yoga is becoming an increasingly popular holistic approach in the West to manage long-term health conditions. This study presents the evaluation of a pilot yoga intervention, Yoga4Health, that was developed for the NHS to be socially prescribed to patients at risk of developing specific health conditions (risk factors for cardiovascular disease, pre-diabetes, anxiety/depression or experiencing social isolation). The aim of this qualitative study was to explore service users’ experiences of Yoga4Health and the acceptability of the programme. Methods Qualitative data were collected from three sources: 1. Open-ended questions on questionnaires completed by services users at three different time-points (baseline, post intervention and 3 months); 2. Interviews and focus groups with a subset of participants (n = 22); 3. interviews with yoga teachers delivering Yoga4Health (n = 7). Each data source was analysed thematically, then findings were combined. Results Of participants completing baseline questionnaires (n = 240), 82.5% were female, 50% White, with a mean age of 53 (range 23–82) years. Baseline questionnaires revealed key motivations to attend Yoga4Health were to improve psychological and physical health, and believing Yoga4Health would be accessible for people with their health condition. Post-intervention, participants reported a range of benefits across psychological, physical and social domains from Yoga4Health. Increased confidence in self-management of health was also reported, and a number of participants described making positive lifestyle changes after attending the programme. Unanticipated benefits of yoga emerged for participants, such as enjoyment and social connectedness, which facilitated ongoing attendance and practice. Also key to facilitating practice (during and after the intervention) were suitability of the classes for those with health conditions, practising with a group and qualities of the yoga teacher. Home practice was supported by course materials (manual, videos), as well as the teaching of techniques for everyday application that offered immediate benefits, such as breathing practices. Follow-up questionnaires revealed a key challenge was continuation of practice once the intervention had finished, with the structure of a class important in supporting practice. Conclusions Yoga4Health was a highly acceptable intervention to services users, which brought a range of biopsychosocial improvements, suggesting yoga is an appropriate intervention to offer on social prescription.
... Accordingly to a meta-analysis of the association of yoga with depression compared with aerobic exercises [32], a moderate effect size of 0.59 was reported. Assuming an attrition rate of 25%, a minimal sample size of 126 participants with 63 participants per arm was needed to provide a 2-arm trial with 80% power to detect an effect size of at least 0.59 at a 5% level of significance. ...
Article
Background: Although several studies have reported positive effects of mind-body exercises on symptom management and health-related quality of life (HRQOL) of people living with Parkinson's disease (PD), it is not known whether these effects are attributable to a change in anxiety and depression. Purpose: To compare the effects of mindfulness yoga to conventional stretching exercises in a randomized controlled trial while examining potentially mediating effects of anxiety and depression. Methods: 138 adults with PD were randomized to eight weekly yoga (n = 71) or stretching (n = 67) sessions. Symptom experiences, anxiety and depression, and HRQOL outcomes were assessed at baseline, immediate post-intervention, and 3-month post-intervention. Results: Generalized estimating equation analyses revealed that, compared to stretching, yoga significantly improved patients' nonmotor (time-by-group interaction, T1:β = -1.99, p = .008; T2:β = -2.86, p < .001) and motor (time-by-group interaction, T1:β = -1.77, p = .03) symptom experiences. The mediation analysis found that the changes in anxiety and depression were the mediators in the associations between non-motor experience and HRQOL; while only the changes in depression were found to be the mediator in the relationship between motor experience and HRQOL. Conclusions: Yoga is superior to conventional stretching exercises in improving nonmotor and motor symptoms in daily living. Reduced anxiety and depression play a role in mediating the positive effects of the mindfulness yoga intervention. To optimize HRQOL, rehabilitation should reinforce psychological care in addition to pharmacological treatments and physical relief of PD symptoms. Future studies are needed to identify strategies for facilitating the implementation and sustainability of mind-body rehabilitation to enhance the quality of care for PD.
... So much so that the National Institute for Care Excellence endorses MBCT as an effective treatment for preventing relapse in clinical depression (Crane & Kuyken, 2013). Reviews also report the benefits of yoga and other mind-body interventions in improving depression and increasing mental health generally (Bridges & Sharma, 2017;Cramer et al., 2013;Domingues, 2018), particularly when delivered in adjunct with other treatments (Taylor et al., 2020). Preliminary research also supports the use of MBIs for bi-polar disorders and eating disorders (Dunne, 2018;Key et al., 2017;Salcedo et al., 2016). ...
Article
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Mindfulness-based interventions (MBIs) are associated with increased psychological wellbeing. The literature suggests that individuals exposed to adverse childhood experiences (ACEs) may benefit greatly from MBIs. However, research has tended to focus on universal MBIs for this population with less attention on the effectiveness of targeted approaches. Moreover, there is growing concern regarding the methodological rigor of MBI research. This systematic mixed studies review (SMRS) reports the effectiveness of MBIs for improving mental health and cognition among individuals with ACE histories. Additionally, the review reports the quality and rigor of the included research. Systematic searches of PsycInfo, EMBASE, MEDLINE, ProQuest Dissertations and Theses, ProQuest Social Science database and the Child Development and Adolescent Studies database were conducted. Results were screened and data were extracted then synthesized using a data-based convergent synthesis design. Thirteen studies were included in the final review. Six prominent themes emerged. Themes indicated that MBIs were effective for improving mental health and cognition for individuals with ACEs. For example, improvements in mood and anxieties, as well as a better ability to manage emotions. Shortcomings in the quality of MBI research included lack of reporting of methodological details (e.g., randomization procedures) and not systematically reporting adverse event evaluations. Recommendations are made for future research to strengthen the evidence base for MBIs for individuals with ACEs.
... and there have been scientific reports of its utility in the reduction of stress, [12,13] anxiety, [14,15] and depression, [15,16] resulting an enhanced quality of life [17] as well as better pain management in chronic disease. [18] Studies show that yoga-based methods help in managing chronic pain restoring autonomic balance and reducing the disability associated with chronic disease conditions. ...
Article
... Auch für "Mind-Body-Therapien" wie bspw. Yoga liegt eine gute Evidenz bezüglich der Reduktion der Schwere von Depressionssymptomen vor [42,43]. ...
Article
Zusammenfassung Depressive Menschen sind im Vergleich zur Allgemeinbevölkerung körperlich eher inaktiv. Sie leiden häufiger unter Herz- und Stoffwechselerkrankungen oder chronischen Entzündungen. Und sie sterben deutlich früher. Ziel der Sporttherapie bei Depression sollte, neben der Verringerung depressiver Symptomatiken, auch die Senkung der erhöhten Komorbidität und Mortatlität sein.
... 12 In contrast, research in complementary health care approaches has increased and significant data exist on the benefit of certain practices in some illnesses. [13][14][15] In the next section, we discuss the current evidence-based management protocols in some common physical and psychiatric illnesses. ...
Article
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With the advent and acceptance of biological medicine, now called as modern biomedicine (or allopathy), the older regional medical systems were categorized as complementary and alternative medicine (CAM). Recently, the term CAM has been replaced with ''integrative medicine.'' This viewpoint manuscript focuses on the essential connotation of such terms and clarifies the debates on the several confusing terminologies hampering its actual conceptualization and leading to the ''othering'' phenomenon in health care approaches. Integrative medicine, in its essence, is a form of holistic and evidence-based health care approach that includes but is not limited to medical treatment. A closer look at the current management protocols of most noncommunicable diseases, such as diabetes mellitus, hypertension, obesity, pain syndromes, and psychiatric illnesses reveals that it incorporates relevant evidence-based management of all health care domains, along with mainstream pharmacologic and surgical treatment options. These management approaches point toward an already existing integration in the mainstream medical practice. Simultaneous management of all the dimensions of health and illness by expanding the current sphere of integration will ultimately result in comprehensive patient care. Therefore, we conclude that integrative medicine is essentially an application of different ''culturally sensitive'' health care approaches, optimally tailored to a given patient's needs and difficulties. Efforts are needed at the clinical, research, and administrative levels to reduce the ''othering'' phenomenon seen in health care approaches that are often detrimental to efficient patient care. There is a need to promote collaboration between different disciplines and generate evidence base to optimize integrative medical practice further. Establishing interdisciplinary departments of integrative medicine at mainstream medical institutions may be the first step in this direction.
... [21] Schools of thought and evidence-based treatments proposing the causative factors, theoretical extent, and impact on individual lives have been extensively progressive in multi-disciplinary approaches in community-based primary care for mental health. [16,18,22,23] Cross-cultural and cross-ethnic differences in the prevalence and the psychopathological relevance are extremely crucial in understanding its presentation in the population, bound to be affected by other socio-economic changes such as migration as well. [24] Social support has been linked to depression through life-stage approaches in various studies in the last three decades. ...
Article
Context: The extent of depressive disorders is wide in the Indian population as reported by epidemiological studies, warranting a necessary area of intervention to cover the rampant treatment gap. Social support is known to vary as per the community-level changes, which may be attributed to events kickstarted by COVID-19. Objectives: This study aimed to assess the social support among persons with depressive disorders. Methods: This was a cross-sectional study conducted among 75 individuals of age ranging from 18 to 46 years from multi-ethnic communities across India. We used the Beck Depression Inventory-II and Multidimensional Scale of Perceived Social Support. Results: This sample had a mean age of 32 years (SD: 7.88 years), and recurrent depressive disorder was the larger prevalent psychopathology diagnosed during their routine clinical consultation in the hospital (69.3%). The majority of the respondents experienced moderate depression (n = 42), followed by mild depression (n = 14) and severe depression (n = 5). Social support and resilience were found to be mildly correlated with each other for persons with mild depression (r = 0.620; P = 0.018). Conclusion: Persons with mild depressive features may benefit from low-cost and community-based interventions directed to enhance social support and thus impact resilience. Psychosocial interventions must address the impact of moderate depression and recurrent depressive disorder and include social support at all spousal, family, and societal levels.
... MBP are considered to have beneficial effects on cognitive function in adulthood (Oken et al., 2006;Zhang et al., 2018). MBP can be performed through different physical activities or movement therapies (including meditative practices) that connect the body and the mind and impact both brain and behavior (Cramer et al., 2013). For example, yoga, an ancient Indian system of philosophy, commonly used as a mind-body interrelated practice, consists of physical movement (asanas), breathing exercises (pranayama), and meditation (dhyana) (Carim-Todd et al., 2013;Hariprasad et al., 2013). ...
Article
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It is widely established that physical activity is associated with better cognitive outcomes, and accumulating evidence suggests that mind-body practice (MBP, e.g., movement therapies such as yoga) may yield similar benefits. Personality is related to both daily activities and cognition, but its role in the association between MBP and cognition is not well understood. Using data from waves 2 and 3 (2004–2014) of the Midlife in the United States (MIDUS) study, the current study examines bidirectional temporal associations between personality traits, MBP, and cognition in healthy adults (N = 2050). We applied a cross-lagged regression analysis to examine bidirectional effects between MBP, Big Five personality traits, and two cognitive domains (episodic memory and executive function) and controlled for relevant variables (sociodemographic factors, health, and functional status) at wave 2. MBP at baseline was independently associated with more favorable change in episodic memory, but not in executive function, both before and after including control variables. Also, episodic memory and executive function at baseline were related to increase in MBP. The findings show that MBP and cognitive function predict each other over time. There is also some evidence for cognition and personality associations over time; however, personality traits are not related to subsequent MBP.
... MBP are considered to have beneficial effects on cognitive function in adulthood (Oken et al., 2006;Zhang et al., 2018). MBP can be performed through different physical activities or movement therapies (including meditative practices) that connect the body and the mind and impact both brain and behavior (Cramer et al., 2013). For example, yoga, an ancient Indian system of philosophy, commonly used as a mind-body interrelated practice, consists of physical movement (asanas), breathing exercises (pranayama), and meditation (dhyana) (Carim-Todd et al., 2013;Hariprasad et al., 2013). ...
Article
Full-text available
It is widely established that physical activity is associated with better cognitive outcomes, and accumulating evidence suggests that mind-body practice (MBP, e.g., movement therapies such as yoga) may yield similar benefits. Personality is related to both daily activities and cognition, but its role in the association between MBP and cognition is not well understood. Using data from waves 2 and 3 (2004–2014) of the Midlife in the United States (MIDUS) study, the current study examines bidirectional temporal associations between personality traits, MBP, and cognition in healthy adults (N = 2050). We applied a cross-lagged regression analysis to examine bidirectional effects between MBP, Big Five personality traits, and two cognitive domains (episodic memory and executive function) and controlled for relevant variables (sociodemographic factors, health, and functional status) at wave 2. MBP at baseline was independently associated with more favorable change in episodic memory, but not in executive function, both before and after including control variables. Also, episodic memory and executive function at baseline were related to increase in MBP. The findings show that MBP and cognitive function predict each other over time. There is also some evidence for cognition and personality associations over time; however, personality traits are not related to subsequent MBP.
... Thus, more randomized control trials with a longer duration as well as more patients are needed. However, in the short term, there is moderate evidence supporting that yoga interventions as an ancillary treatment could be superior compared to usual pharmacological treatments [29]. ...
Article
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Major depression is a devastating disease affecting an increasing number of people from a young age worldwide, a situation that is expected to be worsened by the COVID-19 pandemic. New approaches for the treatment of this disease are urgently needed since available treatments are not effective for all patients, take a long time to produce an effect, and are not well-tolerated in many cases; moreover, they are not safe for all patients. There is solid evidence showing that the antioxidant capacity is lower and the oxidative damage is higher in the brains of depressed patients as compared with healthy controls. Mitochondrial disfunction is associated with depression and other neuropsychiatric disorders, and this dysfunction can be an important source of oxidative damage. Additionally, neuroinflammation that is commonly present in the brain of depressive patients highly contributes to the generation of reactive oxygen species (ROS). There is evidence showing that pro-inflammatory diets can increase depression risk; on the contrary, an anti-inflammatory diet such as the Mediterranean diet can decrease it. Therefore, it is interesting to evaluate the possible role of plant-derived antioxidants in depression treatment and prevention as well as other biomolecules with high antioxidant and anti-inflammatory potential such as the molecules paracrinely secreted by mesenchymal stem cells. In this review, we evaluated the preclinical and clinical evidence showing the potential effects of different antioxidant and anti-inflammatory biomolecules as antidepressants, with a focus on difficult-to-treat depression and conventional treatment-resistant depression.
... Mind-body practices, such as yoga, have been added to ED prevention and treatment approaches to provide opportunity for those at-risk to experience, connect with, and appreciate their bodies and increase positive embodiment (Allen, 2016;Cook-Cottone & Douglass, 2017;Cramer et al., 2013;Douglass, 2010;Halliwell et al., 2019;Kramer & Cuccolo, 2019;Levine, 2020). Specifically, yoga is a practice that integrates mind and body; it typically includes the practices of yoga postures and sequences (asana), breathing techniques, relaxation, mindfulness, and meditation (Anderson & Sovik, 2000;Cook-Cottone, 2015a;Cook-Cottone, 2020;Douglass 2010;National Center for Complementary and Integrative Health (NCCI, 2022). ...
Article
Evidence positions yoga as a promising intervention for enhancing positive embodiment and supporting the prevention of, and recovery from, eating disorders (EDs) by reducing ED symptomatology and building skills that facilitate an ongoing, embodied sense of wellbeing. However, yoga-based programs are few and rigorous literature on their efficacy is limited. This study examined the efficacy and feasibility of a yoga-based program called Eat Breathe Thrive (EBT) which aims to prevent EDs and support embodiment. Participants (N = 168, 93.5 % women) from a community sample in the United States and United Kingdom, ages 18–65, were randomly allocated to a 2-h, 7-week EBT program or waitlist-control condition. Compared to controls, EBT participants experienced significant decreases in ED behaviors, depression, and difficulties regulating emotions. They reported significantly greater use of mindfulness skills, such as interoceptive awareness, mindful self-care, and mindful eating. After a single session, participants reported immediate improvement in their sense of well-being, indicating increased state positive embodiment. Most effects were sustained at 6-month follow-up. The majority of individuals attended most sessions. Self-reported treatment integrity was excellent. Directions for future research are proposed. Results support the efficacy and feasibility of an integrated yoga intervention that fosters positive ways of inhabiting the body.
... Групповой формат занятий может быть более эффективен, чем индивидуальный, для пациентов с симптомами депрессии, тревоги [14]. При повышенной тревожности и отвлекаемости на беспокойные, негативные мысли во время занятий пациенту может быть предложен специальный вид упражнений -осознанные физические упражнения (mind body exercise), которые включают в себя техники медитации [31,32]. ...
Article
A combined approach is recommended to treat chronic non-specific low back pain (lumbago), including pharmacological and non-pharmacological methods. Kinesiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs) have a high level of evidence in chronic lumbago. Kinesiotherapy includes posture and daily motor activity regimen training, a complex of therapeutic and breathing exercises, post-isometric relaxation, and other physical exercises. NSAIDs reduce pain, improve functional status, and increase patients' adherence to kinesiotherapy, relieving pain in the first days of treatment. A specific NSAID administration is usually individualized, considering the comorbidities and the risk of possible side effects. The use of meloxicam (Movalis) for back pain is discussed.
... Moreover, it has been confirmed as an effective measure on creating a connection between mind and body and creating balance in the body, leading to the reduced stress, anxiety, and depression. [6][7][8] Yoga is also used for various aspects of health promotion, from reducing the menopausal symptoms to reducing labor pain and palliative therapies in the treatment of cancer. [9][10][11][12] During the current COVID-19 pandemic, yoga and meditation are considered and used as an alternative and complementary approach. ...
... However, traditional yoga encompasses a multiplicity of components [11], and little is known about which differential health benefit is associated with which yoga component. 3 of 24 In addition to the lack of differentiation and systematic investigation, the methodological quality of yoga studies has often been poor [40,41]. Dismantling or comparative studies with several repeated measurements, such as experience sampling or single-case research designs [42,43], provide a promising approach in this regard. ...
Article
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Yoga is an embodied contemplative practice considered as a path toward long-term well-being, which fosters an integrated processing of bodily and emotional stimuli. However, little is known about how the different components of yoga contribute to these processes. This was the aim of this single-case multiple-baseline study. Herein, we explored how different yoga components affect body awareness, emotion regulation, affectivity, self-compassion, and distress tolerance. Forty-two randomly assigned participants (from initially fifty-seven) completed one of four 8-week treatments: Mantra meditation alone (MA), meditation plus physical yoga (MY), meditation plus ethical education (ME), and meditation plus yoga and ethical education (MYE). Participants had no prior regular yoga or meditation practice. Data were analyzed using visual inspection, effect size estimation, and multilevel modeling. Surprisingly, all four treatments similarly improved body awareness (Tau-UMA = 0.21 to Tau-UMY = 0.49), emotion regulation (Tau-UMYE = −0.43 to Tau-UME = −0.52), self-compassion (η2 = 0.08), and distress tolerance (η2 = 0.13). These effects were maintained until follow-up at 2 and 12 months after the study, even though home practice declined. The MA condition had the least favorable effect on affective experience (Tau-UMA = −0.14 and 0.07), while the ME condition enhanced valence the most (Tau-UME = 0.10) and the MY condition was the most effective in preventing negative affective responses. Although mantra meditation on its own negatively influenced daily affect, it can be assumed as the driving force behind the improvement in the other variables. This points to the central role of meditation in increasing interoception, self-awareness, and embodied processing.
... There was moderate evidence for yoga's short-term effects compared to usual care concerning the severity of depression. The review concluded that despite methodological drawbacks in the studies, yoga could be considered an add-on treatment option for patients with depressive disorders (Cramer et al., 2013). ...
Chapter
This chapter is divided into four subsections: the first section of the chapter provides an update on current evidence for yoga therapy in common mental health disorders, the second section provides brief overview on neurophysiological abnormalities in psychiatric disorders and their relationship with psychological stress, the third section deals with summary of evidence for neurophysiological effects of yoga in mental health disorders, and the last section emphasizes on practical aspects of yoga therapy with details of clinically useful yoga practices for common mental health disorders. The mental health disorders covered in this chapter include depression, anxiety, schizophrenia, child and adolescent psychiatric disorders, substance use disorders, and geriatric psychiatric disorders.
Article
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Objective Depression is a global key challenge in mental health care. The implementation of effective, low‐risk and cost‐effective interventions to reduce its disease burden is a necessity. The aim of this study was to investigate the efficacy of the new Meditation‐Based Lifestyle Modification (MBLM) program, a “second‐generation” mindfulness‐based intervention, in depressive outpatients. Methods Eighty‐one patients with mild to moderate depression were randomized into three groups: intervention group (MBLM), control group (CONTROL), and treatment as usual group (TAU). The primary outcome was the change of depressive symptoms as administered by the Beck Depression Inventory‐II (BDI‐II) after 4 and 8 weeks. Secondary outcome variables included the Brief Symptom Checklist‐18 and the Perceived Stress Scale‐10. A 6‐month follow‐up was conducted. Results A greater reduction of depressive symptoms was found in MBLM participants compared to CONTROL (p < .001, ηp² = 0.11, d = 0.70) and TAU (p < . 001 , η p 2 = 0 . 10 , d = 0 . 67 $p\lt .001,{\eta }_{{\rm{p}}}^{2}=0.10,d=0.67$) with a 13.15 points reduction of BDI‐II score versus 1.71 points (CONTROL) and 3.34 points (TAU) after 8 weeks. Between‐group post hoc tests for all secondary outcomes and at follow‐up also yielded significant between‐group differences with medium to large effect sizes in favor of MBLM. Conclusions Study results showed beneficial effects of MBLM in depressed outpatients. Further high‐quality controlled clinical studies including qualitative research are needed to investigate the specific and unspecific effects of the MBLM program in depression and other medical conditions.
Article
Background: Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking. Materials and Methods: This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence‐based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders. Results: Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi‐experimental research designs. Discussion: Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD. Conclusions: Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence‐based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice. KEYWORDS: anxiety, complementary therapy, depression, eating disorders, evidence‐based psychological treatment, mapping review, posttraumatic stress disorder, yoga
Article
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COVID-19 pandemic is dreadful and a lot spreading rates in Yangon, Myanmar. COVID-19 pandemic was first reported by official in Wuhan City, China, in December 2019 and only on 23 rd March, 2020, two COVID-19 patients were found in Yangon, the second Capital City of Myanmar. Yangon was the first place that found COVID-19 patients and became the most COVID-19 patients in Myanmar and also Yangon have the most population of migrant workers and then a lot of job opportunities for youths of Myanmar. The educational level of Yangon is the best in Myanmar. During COVID-19 periods, even some private schools and some Universities of Yangon have online teaching system, students and their parents don't like online teaching system and most students want to study physically and some students of private schools left the schools. So, private teachers neither were fired job nor got their salaries since 30 th June. Except office servants of some companies related to commodity and technology, other migrant workers faced with releasing their salaries and allowances including work overtime and their apartments. 50 percentage of migrant workers lose their jobs and 75 percentage of population of Yangon felt depression in Myanmar. In Yangon, public psychological status, economy and education suffered in high percentage while COVID-19 period.
Article
Purpose: This systematic review of randomised controlled trials (RCTs) aimed to determine the effects of mind-body therapies (MBTs) among older adults with dementia. Methods: We searched five electronic databases (PubMed, PsycINFO, Web of Science, EMBASE, and the Cochrane Library) for publications investigating the effect of MBTs until July 14th, 2020. We included published peer-reviewed RCTs among participants with a mean age of 60 and above and a diagnosis of any dementia. Eligible studies included measurements for all types of health outcomes, including cognitive function, neuropsychiatric inventory, depressive syndromes, agitation, psychosocial status, and other health outcomes. Two investigators extracted data, the risk of bias for each study was evaluated through Review Manager, and statistical meta-analysis was performed using Stata. Results: A total of nine studies met the eligibility criteria, with full-text available for systematic review. Five of them, with 338 participants, were included in the meta-analysis. For most included RCTs of the review, the methodological quality was moderate. The meta-analysis showed that Tai Chi had a mild effect on global cognitive function (Mini-Mental State Examination, SMD = 0.40, 95% CI 0.10-0.70). Yoga and aromatherapy may also be beneficial for depression, and these three MBTs improved quality of life. Conclusion: The current review suggested that MBTs may act as potential non-pharmaceutical approaches to improve certain health outcomes among older populations with dementia. Systematic review and meta-analysis registration: PROSPERO CRD42021198514.
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Os capítulos 1 a 5 apresentam o contexto de inserção das PICS na sociedade ocidental, sua potência como práticas terapêuticas num ambiente dominado pela visão biomédica, suas limitações e as possibilidades de avaliação de seus benefícios usando os métodos consagrados para produção e síntese de evidências na área da saúde. Os capítulos 6 a 11 apresentam o método e os resultados de mapas de evidências sobre a efetividade de várias PICS como recurso terapêutico: acupuntura e auriculoterapia, meditação e mindfulness, plantas medicinais e fitoterápicos, práticas corporais da medicina tradicional chinesa e yoga. Por fim, os capítulos 12 a 14 apresentam experiências e estudos sobre a implementação de políticas e programas de PICS.
An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed.
Article
Yoga is the science of conditioning one's mind and body via the practise of shatkarma, asana, pranayama, mudra, and meditation. The aim of this review of literature is to give theoretical rationale for identifying (a) the specific attributes of yoga poses that have been used in yoga protocols of various studies but have not been explicitly explored, & (b) the minimum time necessary to keep a posture to bring about a corresponding change in performance among the aforementioned cognitive functions (s) In humans, The most prevalent and under-treated problems are cognitive decline & psychological health problems. Different studies have been carried out to determine the influence of Yoga on human cognitive and psychological health indices. However, no comprehensive examination of the effects of yoga-based therapy on human cognitive and mental health has been undertaken to far. Yoga is an ancient science that places a premium on disease prevention and treatment, as well as the percentage of health. Yoga is recognized to delay the effects of aging and has been found to be effective in the therapy of aging-related disorders. Yoga is a centuries-old discipline that is said to improve both physical and emotional well-being.
Article
Background: In December 2019, a new corona-virus (COVID-19) infection broke out in the Chinese province of Wuhan. With the rampant spread of virus around the world, COVID-19 was declared as a global pandemic in the following year. Many complementary and alternate therapies (CAM) were used experimentally alongside conventional treatments for effective management of COVID-19. Aim: This paper presents a protocol for the systematic review and meta-analysis of the studies with various CAM therapies for the management of COVID-19 pneumonia. Methods: Electronic databases such as PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) could be used for searching the relevant trials and studies with keywords related to COVID-19 and CAM therapies. Two independent reviewers would screen a list of all the trials and extract the relevant variables. Additionally, we would also evaluate the risk of bias of the selected studies. Review Manager software (RevMan; version 5.3.5) and R statistical software (version 3.6.1) would be used for the data analysis. Results: Risk ratio (RR) would be estimated for dichotomous outcomes, and the mean differences (MD) would be measured for continuous outcomes. Heterogeneity with the help of I ² statistic would be used for the assessment of inconsistency across studies with the level of significance at P< 0.10. We would also assess publication bias using funnel plots and Egger’s test for the selected studies. Conclusion: The protocol for systematic review and meta-analysis would investigate the beneficial and possible adverse effects of various CAM therapies in the prevention and management of COVID-19 associated pneumonia.
Article
Introduction: Chronic stress and burnout are highly prevalent among academically trained healthcare professionals, negatively affecting their well-being and capacity to engage in their work. Resilience to stress develops early in one's career path, hence offering resilience training to university students in these professions is one approach to fostering well-being and mental health. The aim of this study is to assess whether offering mindfulness-based resilience training to university students in healthcare professions reduces their perceived chronic stress. Methods and analysis: The study has a hybrid design combining a longitudinal observational cohort with a nested randomized controlled trial (RCT) with sequential multiple assignment and multistage adaptive interventions while taking participants' preferences into account. All students in healthcare related programmes at the Erasmus University Rotterdam are invited to participate. Within the observational cohort, students with a score of 14 or higher on the Perceived Stress Scale (PSS) are invited to take part in the RCT (n = 706). Eligible participants are randomized to control or active intervention in a ratio of 1:6. Those randomized to the control group and non-randomized participants in the cohort receive passive web-based psychoeducation about chronic stress and burnout through referral to specific websites. Participants randomized to the intervention group receive one of 8 active mindfulness-based interventions. They select a rank order of 4 preferred interventions and are randomized across these with equal probability. Non-response to the intervention is followed by sequential randomized assignment to another intervention, for a total maximum of 3 sequential interventions. All participants receive questionnaires at baseline, before and after each 8-week intervention period, and at 1- and 2-year follow-up. The primary outcome is perceived chronic stress measured with the PSS. Secondary outcomes include mental well-being, burnout, quality of life, healthcare utilization, drug use, bodyweight, mental and physical stress-related symptoms, resilience, and study progress. Ethics and registration: Approval from the Medical Ethics Review Committee was obtained under protocol number MEC-2018-1645. The trial is registered in the Netherlands National Trial Register by registration number NL7623, 22/03/2019, https://www.trialregister.nl/.
Article
Introduction COVID-19 has caused an unprecedented psychological affection that might impact the nationwide vaccination program in China. This study was to explore the association between COVID-19 vaccination and psychological disorders among healthcare workers. Methods The study included 1571 healthcare workers from an anonymous online survey. Participants' sociodemographic characteristics, uptake data for the COVID-19 vaccine, and scores of the Depression, Anxiety, and Stress Scale (DASS-21) were collected. Nonparametric tests were conducted to compare the mean scores of DASS-21 between different subgroups. The potential factors related to psychological disorders of healthcare workers were analyzed using logistic regression. Results The vaccination rate was 69.6 %, the incidence of vaccine-related adverse events was 35.13 %, and the prevalence of depression, anxiety, and stress were 24.8 %, 32 %, and 33.4 % in this study, respectively. Compared to vaccinated participants (single-dose and double-dose vaccines), unvaccinated participants got significantly higher mean scores of DASS-21 (p < 0.05 for all). Vaccinated participants who suffered no adverse events scored significantly lower than those who suffered 1–2 or ≥3 adverse events (p < 0.05 for all). Vaccination was negatively associated with higher depression, anxiety, and stress, however, the number of vaccine-related adverse events was positively associated with them. Limitations As this is a cross-sectional study, we could only speculate on the causality. Conclusions An obvious impact of the psychological disorders on the COVID-19 vaccine coverage and related adverse events was detected in this study. Public health agencies should attach great importance to the psychological states of our citizens before getting vaccinated.
Article
Purpose To compare the effects of yoga, aerobic exercise, and usual care on anxiety and depressive symptoms in non-treatment seeking adults with AUD. Method Parallel, three-group, open-label randomized (1:1:1) controlled trial with blinded follow-up assessment. Non-treatment seeking adults (aged 18–75 years) were recruited via advertisements in a free newspaper in Stockholm, Sweden. All participants had clinician-diagnosed AUD prior to randomization. This trial excluded those who were physically active, or for whom supervised physical activity was contraindicated. Participants were randomly assigned to 12-weeks of aerobic exercise, yoga, or usual care (telephone counselling). The secondary outcome of interest was the Hospital Anxiety and Depression Scale (HADS), assessed at baseline and 12-week follow-up. Primary analyses consisted of linear regression models and followed intention-to-treat (ITT) principals. Results In total, 140 participants (mean age 53.7 years, SD=11.8) were recruited. Follow-up was completed for 42/45 participants randomized to TAU, 42/49 to aerobic exercise and 43/46 to yoga. ITT analyses included 126 trial participants. There were statistically significant within-group improvements in total HADS in all three intervention groups. Effect sizes for usual care and aerobic exercise were small (Hedges’ g=0.48, 95% CI=0.16, 0.80 and g=0.41, 95% CI=0.09, 0.72, respectively), while yoga was associated with a large treatment effect (g=1.06, 95% CI=0.69, 1.43). There were significant between-group differences in these improvements favouring yoga (B=-2.15, 95% CI=-4.16, -0.15, p=.035) relative to usual care, but no significant differences between yoga and aerobic exercise. No injuries were reported. Conclusions Findings support the recommendation of yoga for non-treatment seeking adults with AUD.
Article
Purpose/objective: Research on third-wave cognitive behavioral therapies has burgeoned over the last ten years. However, questions remain about the effectiveness of these therapies for people with epilepsy. This article provides an up-to-date review of the current evidence-base. Methods: Following protocol registration (PROSPERO CRD42021269882), two reviewers searched six databases (from inception until 1 March 2022) for mindfulness and acceptance interventions targeted at mental health in adults with epilepsy. The reporting quality of included studies was rated (QualSyst tool) and standardized mean group differences (Hedges’ g) with 95% confidence intervals and p values calculated. Results were narratively synthesized based on therapy characteristics and mental health outcome. Results: Eleven randomized controlled trials, involving 941 adults with chronic epilepsy, were included. All studies were of sound methodological quality. Third-wave therapies were typically delivered in a group format although varied in their face-to-face, telephone, and online learning options. Programs evaluating Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy, or elements of both, outperformed wait-listed controls or usual care, although individual variability in treatment response was evident (g range = −0.11–2.28). Conclusions: Acceptance techniques and mindfulness practice may bring mental health benefits for some people living with epilepsy, but do not have consistent results for everyone. Patient diversity and preferences need to be factored into effective third-wave approaches for this cohort.
Article
Background Posttraumatic stress disorder (PTSD) is a common sequela to military sexual trauma (MST) among women veterans. Yoga has shown promise in research examining its benefit for symptoms and sequela of PTSD. Aims The objective of this study was to evaluate the feasibility of a randomized controlled trial (RCT) of Trauma Center Trauma-Sensitive Yoga (TCTSY) for women veterans with PTSD related to MST. Method In this feasibility study, the final sample included women veterans ( n = 41) with PTSD related to MST accessing health care in a Veterans Affairs Health Care System in the southeast United States; the majority were African American ( n = 33; 80.5%). Interventions used established protocols of 10 weekly sessions of group TCTSY versus 12 weekly sessions of group Cognitive Processing Therapy (CPT). PTSD was assessed via clinical interview and participant report. Additional data collection included multiple participant-reported outcomes commonly associated with PTSD and psychophysiological measures. We also collected data regarding participant satisfaction and feasibility-related feedback from participants and providers. Results Feasibility and acceptability were evaluated via demand, practicality, fidelity, and acceptability. This was measured by expressed interest, attendance, program completion, barriers to care and satisfaction with treatment, and satisfaction with interventions and data collection. Conclusions Results indicate the RCT design and TCTSY implementation were feasible; a full-scale RCT was subsequently conducted to determine efficacy of the experimental intervention. Recommendations for successful research strategies are provided.
Article
Yoga is an Indian philosophy systematized in the Yoga Sutras of Patanjali approximately 2000 years ago as a global life style approach consisting of eight interrelated components. The first component consists of ethical behavior prescriptions toward others (e.g. non-harming) and the second consists of rules of conduct toward the self (e.g. discipline). The third is the practice of physical poses or asana. The fourth is a controlled breathing practice. The fifth consists of controlling sensory input. The following three components are increasingly more advanced levels of meditative practice. Specifically, the sixth component consists of practicing sustained concentration or focused attention on one object. The seventh is a state of absorption in which the entire perceptual flow is directed toward the object. The eighth and final component is a state of integration in which the object is seen as indivisible from the self . The goal of regularly practicing these eight components is to calm the restlessness of the mind so that mental activity can be directed into productive channels and mental pain can be alleviated (Iyengar 1966). Contemporary yoga practices primarily focus on asana, controlled breathing and meditation, with various degrees of emphasis on each of these components (National Center for Complementary and Integrative Health 2016). Yoga incorporating asana, or asana-based yoga, includes traditional practices such as Hatha, Iyengar, Sivananda and Ashtanga.
Article
Background The popularity of yoga and the understanding of its potential health benefits have recently increased. Unfortunately, not everyone can easily engage in in-person yoga classes. Over the past decade, the use of remotely delivered yoga has increased in real-world applications. However, the state of the related scientific literature is unclear. Objective This scoping review aimed to identify gaps in the literature related to the remote delivery of yoga interventions, including gaps related to the populations studied, the yoga intervention characteristics (delivery methods and intervention components implemented), the safety and feasibility of the interventions, and the preliminary efficacy of the interventions. Methods This scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Item for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Scientific databases were searched throughout April 2021 for experimental studies involving yoga delivered through technology. Eligibility was assessed through abstract and title screening and a subsequent full-article review. The included articles were appraised for quality, and data were extracted from each article. Results A total of 12 studies of weak to moderate quality were included. Populations varied in physical and mental health status. Of the 12 studies, 10 (83%) implemented asynchronous delivery methods (via prerecorded material), 1 (8%) implemented synchronous delivery methods (through videoconferencing), and 1 (8%) did not clearly describe the delivery method. Yoga interventions were heterogeneous in style and prescribed dose but primarily included yoga intervention components of postures, breathing, and relaxation and meditation. Owing to the heterogeneous nature of the included studies, conclusive findings regarding the preliminary efficacy of the interventions could not be ascertained. Conclusions Several gaps in the literature were identified. Overall, this review showed that more attention needs to be paid to yoga intervention delivery methods while designing studies and developing interventions. Decisions regarding delivery methods should be justified and not made arbitrarily. Studies of high methodological rigor and robust reporting are needed.
Article
Objectives: This study examines motivations for yoga and identifies unique motivational profiles among a sample of young adult yoga practitioners. This study further determines how young adult yoga practitioners' motivational profiles associate with physical health behaviors and psychological factors. Subjects/Setting: Survey data were drawn from the fourth wave of a large, population-based study (Project EAT-IV; Eating and Activity in Teens and Young Adults). Design: Latent class analysis (LCA) was used to identify motivational profiles among Project EAT-IV participants practicing yoga (n = 297; mean age: 30.8-1.7 years; 79.7 % female). Cross-sectional associations between latent motivational profiles, physical health behaviors, and psychological factors were determined with unadjusted and adjusted (gender, race/ethnicity, and body mass index) general linear models. Results: Across motivational profiles, most young adult yoga practitioners were motivated by enhanced fitness and stress reduction/relaxation. Additional motivations for yoga clustered by appearance (desire to change body appearance or weight) or mindfulness (desire to increase present moment awareness) underpinnings. The LCA characterized motivational profiles as "Low Appearance, Low Mindfulness" (Class 1; n = 77), "Low Appearance, High Mindfulness" (Class 2; n = 48), "High Appearance, Low Mindfulness" (Class 3; n = 79), and "High Appearance, High Mindfulness" (Class 4; n = 93). Having a profile with high mindfulness and low appearance motivations (Class 2) was associated with higher body satisfaction in comparison to the other classes (p < 0.001). Relative to Class 2, those with low mindfulness motivations (Class 1; Class 3) reported less total physical activity (p = 0.002) and those with high appearance motivations (Class 3; Class 4) reported higher compulsive exercise scores (p = 0.002). Conclusions: In this sample, high mindfulness and low appearance motivations for yoga appeared optimal for physical and psychological health. Cross-sectional findings suggest that young adult yoga practitioners' mind-body health may be supported by motivational underpinnings that emphasize yoga's internal (mindfulness) rather than external (appearance) benefits.
Chapter
The experience of stroke can significantly impact the physical health, psychosocial wellbeing of an individual. These consequences make the patients vulnerable to develop mental illnesses, ranging from dysthymia to as serious as severe depression with suicidal tendencies. There is a need for holistic therapies such as yoga-based lifestyle, which aim at improving quality of life on both physical and psychosocial domains. There is growing evidence indicating the potential use of yoga in improving an individual’s functional status post-stroke. This chapter aimed at reviewing the evidence for the effects of yoga in the prevention of stroke and its post-stroke rehabilitative potential. The literature suggests the need for integration of yoga therapy with the conventional treatment to curb the morbidity and mortality associated with stroke and its co-morbidities.
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Common mental health co-morbidities such as stress, depression, and anxiety are explained along with their deleterious effects on the cardiovascular system. Numerous scientific studies on yoga in mental health co-morbidities and cardiovascular diseases (CVDs) are discussed in this chapter. The chapter also describes possible mechanisms of yoga in improving mental health parameters and provides different yoga modules for CVD patients with various mental health co-morbidities.
Article
Purpose Given increasing rates of depression in adolescents, there is a clear need for innovative treatments. In this pilot randomized clinical trial, we assessed acceptability and feasibility of two group-based interventions: yoga and cognitive-behavioral therapy (CBT). The goal of this work is to prepare for a future fully powered randomized trial to test the hypothesis that yoga is not inferior to an established adolescent depression treatment, namely, group CBT. Methods We enrolled 42 adolescents with elevated depression symptoms. Participants were randomly assigned to a 12-week group-based intervention, yoga or CBT. We had a priori feasibility and acceptability targets, including for recruitment rate, retention rate, expectancy, credibility, program satisfaction, class attendance, engagement in home practice, and instructor/leader manual adherence. We assessed adverse events, and within-subject changes in outcomes (depression, anxiety, impairment, sleep disturbance) and possible mediators (mindfulness, self-compassion). Results Both interventions met most acceptability and feasibility targets. The only target not met related to low engagement in home practice. Participants within each study arm showed decreased depression symptoms over time and increased self-compassion. Conclusions A yoga intervention appears to be acceptable and feasible to adolescents with depression. However, it may be challenging for this group to engage in unstructured home practice.
Article
Objective This aim of the study was to explore the effectiveness of an online trauma-informed yoga program to increase positive mental health and reduce stress in the general population. Design This was a mixed-methods prospective intervention study with an active traumainformed yoga group and a wait-listed control group. Methods Thirty participants were recruited from an organisation based in the United Kingdom.The active intervention was a once weekly pre-recorded TIY video class (approximately one-hour) for 10 weeks. The control group were wait-listed. The primary outcome was a comparison between the active and control groups postintervention on the positive mental health scale. Secondary outcomes were the difference between groups over various related scales. ANCOVA was used in the analysis to respectively control for baseline levels of the outcomes. Results A non-significant increase in PMH ( b = 2.44, p = 0.16), mindfulness ( b = 6.35, p = 0.07) and resilience ( b = 4.08, p = 0.15 and a significant increase in selfcompassion ( b = 2.53, p = 0.04) were demonstrated, while perceived stress increased non-significantly ( b = 1.51, p = 0.56) and empowerment was reduced non-significantly ( b = -0.25, p = 0.29) for the active group compared with controls. Conclusions Consistent trends over multiple outcomes demonstrated positive effects of TIY on PMH, mindfulness, resilience, and a significant improvement in self-compassion. Limitations of a small study include an increased risk of failing to reject the null hypothesis when it is false. A larger trial is warranted to demonstrate the effects of TIY more conclusively in positive mental health.
Chapter
Yoga has been demonstrated to improve well-being and mental health in diverse populations; however, understanding of the mechanisms of action is still developing. This chapter explores the impact of yoga-based interventions on psychological and/or biological mechanisms related to mental health. This chapter highlights that yoga-based interventions decrease stress reactivity, influence physiological markers of stress reactivity, resulting in overall improved health and well-being, in diverse populations of adults. Yoga-based interventions influence psychological processes important in the regulation of mood and emotion, including dispositional mindfulness, self-compassion, rumination, attention, metacognition, and memory. Finally, yoga-based interventions result in structural and functional changes in several brain regions. Yoga-based interventions impact several processes relevant to mental health and maybe a useful complementary intervention for a number of mental health concerns.
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Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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Depression is a clinical disorder distinguished by physiological and psychological markers. Some studies have indicated that during depression some neural chemical transmitters including epinephrine are reduced. It seems that these chemical changes can cause depression symptoms. 3-metoxy-hydroxyphenyl glycol-sulphate (MHPG) is a metabolite of epinephrine that released from presynaptic nerve terminals of central nervous system and became sulphate in brain. It cross the blood-brain barrier and showed as a sulphate combination in urine. The propose of this proposal, was to determine the effect of 8 weeks of aerobic exercise, walking in water and yogic exercise on urine MHPG sulphate in the depressed girls.
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Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results.
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Objectives: This study investigated the perceived influence of yoga on body perception and psychosocial aspects of life for patients with chronic neck pain. Design: This qualitative study was conducted using semistandardized interviews. Setting: The interventions and interviews took place in a referral center's research department. Subjects: Eighteen (18) patients with chronic nonspecific neck pain were recruited from a larger randomized controlled trial of yoga for chronic neck pain. Interventions: Participants attended 90 minutes of Iyengar yoga once a week for 9 weeks. Outcome measures: Participants completed a drawing of their neck and shoulder regions to reflect their subjective body perceptions before and after their yoga program. Semistandardized interviews were used to explore their body perception, emotional status, everyday life and coping skills, as well as any perceived changes in these dimensions postparticipation. An interdisciplinary group analyzed the study data using content analysis techniques. Results: Participants reported change on five dimensions of human experience: physical, cognitive, emotional, behavioral, and social. Physically, most participants cited renewed body awareness, both during their yoga practice and in their daily lives. Such change was echoed in their postparticipation body drawings. Cognitively, participants reported increased perceived control over their health. Emotionally, they noted greater acceptance of their pain and life burdens. Behaviorally, they described enhanced use of active coping strategies. Finally, socially, they reported renewed participation in an active life. Conclusions: Participants linked yoga to change on all dimensions of human experience, attributing reduced pain levels, increased coping ability, better pain acceptance and increased control to it. Body awareness appeared a key mechanism in these changes.
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Background The aim of this review was to systematically review and meta-analyze the effects of yoga on symptoms of schizophrenia, quality of life, function, and hospitalization in patients with schizophrenia. Methods MEDLINE/Pubmed, Scopus, the Cochrane Library, PsycInfo, and IndMED were screened through August 2012. Randomized controlled trials (RCTs) comparing yoga to usual care or non-pharmacological interventions were analyzed when they assessed symptoms or quality of life in patients with schizophrenia. Cognitive function, social function, hospitalization, and safety were defined as secondary outcomes. Risk of bias was assessed using the risk of bias tool recommended by the Cochrane Back Review Group. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Results Five RCTs with a total of 337 patients were included; 2 RCTs had low risk of bias. Two RCTs compared yoga to usual care; 1 RCT compared yoga to exercise; and 2 3-arm RCTs compared yoga to usual care and exercise. No evidence was found for short-term effects of yoga compared to usual care on positive symptoms (SMD = -0.58; 95% CI -1.52 to 0.37; P = 0.23), or negative symptoms (SMD = -0.59; 95% CI -1.87 to 0.69; P = 0.36). Moderate evidence was found for short-term effects on quality of life compared to usual care (SMD = 2.28; 95% CI 0.42 to 4.14; P = 0.02). These effects were only present in studies with high risk of bias. No evidence was found for short-term effects on social function (SMD = 1.20; 95% CI -0.78 to 3.18; P = 0.23). Comparing yoga to exercise, no evidence was found for short-term effects on positive symptoms (SMD = -0.35; 95% CI -0.75 to 0.05; P = 0.09), negative symptoms (SMD = -0.28; 95% CI -1.42 to 0.86; P = 0.63), quality of life (SMD = 0.17; 95% CI -0.27 to 0.61; P = 0.45), or social function (SMD = 0.20; 95% CI -0.27 to 0.67; P = 0.41). Only 1 RCT reported adverse events. Conclusions This systematic review found only moderate evidence for short-term effects of yoga on quality of life. As these effects were not clearly distinguishable from bias and safety of the intervention was unclear, no recommendation can be made regarding yoga as a routine intervention for schizophrenia patients.
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Objectives. To systematically review and meta-analyze the effectiveness of yoga for menopausal symptoms. Methods. Medline, Scopus, the Cochrane Library, and PsycINFO were screened through April 2012. Randomized controlled trials (RCTs) were included if they assessed the effect of yoga on major menopausal symptoms, namely, (1) psychological symptoms, (2) somatic symptoms, (3) vasomotor symptoms, and/or (4) urogenital symptoms. For each outcome, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Results. Five RCTs with 582 participants were included in the qualitative review, and 4 RCTs with 545 participants were included in the meta-analysis. There was moderate evidence for short-term effects on psychological symptoms (SMD = −0.37; 95% CI −0.67 to −0.07; P = 0.02). No evidence was found for total menopausal symptoms, somatic symptoms, vasomotor symptoms, or urogenital symptoms. Yoga was not associated with serious adverse events. Conclusion. This systematic review found moderate evidence for short-term effectiveness of yoga for psychological symptoms in menopausal women. While more rigorous research is needed to underpin these results, yoga can be preliminarily recommended as an additional intervention for women who suffer from psychological complaints associated with menopause.
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Abstract Background Many breast cancer patients and survivors use yoga to cope with their disease. The aim of this review was to systematically assess and meta-analyze the evidence for effects of yoga on health-related quality of life and psychological health in breast cancer patients and survivors. Methods MEDLINE, PsycInfo, EMBASE, CAMBASE, and the Cochrane Library were screened through February 2012. Randomized controlled trials (RCTs) comparing yoga to controls were analyzed when they assessed health-related quality of life or psychological health in breast cancer patients or survivors. Risk of bias was assessed using the Cochrane risk of bias tool. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Results Twelve RCTs with a total of 742 participants were included. Seven RCTs compared yoga to no treatment; 3 RCTs compared yoga to supportive therapy; 1 RCT compared yoga to health education; and 1 RCT compared a combination of physiotherapy and yoga to physiotherapy alone. Evidence was found for short-term effects on global health-related quality of life (SMD = 0.62 [95% CI: 0.04 to 1.21]; P = 0.04), functional (SMD = 0.30 [95% CI: 0.03 to 0.57), social (SMD = 0.29 [95% CI: 0.08 to 0.50]; P
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The prevelance of depression in older people is high, treatment is inadequate, it creates a substantial burden and is a public health priority for which exercise has been proposed as a therapeutic strategy. To estimate the effect of exercise on depressive symptoms among older people, and assess whether treatment effect varies depending on the depression criteria used to determine participant eligibility. Systematic review and meta-analysis of randomised controlled trials of exercise for depression in older people. Nine trials met the inclusion criteria and seven were meta-analysed. Exercise was associated with significantly lower depression severity (standardised mean difference (SMD) = -0.34, 95% CI -0.52 to -0.17), irrespective of whether participant eligibility was determined by clinical diagnosis (SMD = -0.38, 95% CI -0.67 to -0.10) or symptom checklist (SMD = -0.34, 95% CI -0.62 to -0.06). Results remained significant in sensitivity analyses. Our findings suggest that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.
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Background: Summarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study. Method: A systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis. Results: The literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4-5.0%). The pooled annual incidence was 3.0% (2.4-3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD. Conclusions: Our findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.
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Yoga is gaining acceptance as an ancillary medical treatment, but there have been few studies evaluating its therapeutic benefits in neurological and major psychiatric conditions. The authors reviewed the literature in English on the efficacy of yoga for these disorders. Only randomized, controlled trials were included, with the exception of the only study of yoga for bipolar disorder, which was observational. Trials were excluded if yoga was not the central component of the intervention. Of seven randomized, controlled trials of yoga in patients with neurological disorders, six found significant, positive effects. Of 13 randomized, controlled trials of yoga in patients with psychiatric disorders, 10 found significant, positive effects. These results, although encouraging, indicate that additional randomized, controlled studies are needed to critically define the benefits of yoga for both neurological and psychiatric disorders.
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In cases of mental depression, the plasma serotonin, melatonin and glutamate levels are increased along with the lowering of urinary - 5 - hydroxyindole acetic acid, plasma monoamine oxidase and cortisol levels following three and six months Practice of Kundalini Yoga. The pulse rate and blood pressure in these patients are also lowered after Kundalini Yoga practice. Thus, the practice of Kundalini Yoga helps to maintain a perfect homeostasis by bringing an equilibrium between the sympathetic and parasympathetic activities and it can be used as a non - medical measure in treating patients with mental depression.
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The limitations of current methods of treatment for dysthymic disorder justify experimentation with new alternatives. Techniques of yoga hold promise. A brief package; Sudarshan Kriya exerts demonstrable effects on brain functioning and may have effects akin to ECT in depression. Sudarshan Kriya Yoga (SKY) was used to treat 46 hospital out-patients (22 males) of dysthymic disorder. Over 3 months, they had to practice it everyday for half-an hour and avoid any medication. They were assessed initially, at one and 3 months on interviews video-rated and self-report scales. In a subsample of mates (n=12), plasma prolactin and cortisol levels were obtained before and after the first full SKY session. 37 patients completed the treatment through three months and 25 (68%) of them remitted. A higher proportion of those practising SKY regularly remitted. Significant elevation of plasma prolactin, but not cortisol occurred after the first SKY session. SKY has demonstrable biological effects and is therapeutic in dysthymic disorder.
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Unipolar depression is the most common mood disorder and previous studies have demonstrated autonomic dysregulation in patients of major depression. Present study was carried out to assess the efficacy of Sahaj yoga meditation on autonomic parameters in healthy subjects & patients of major depression. The study was carried out on 30 patients suffering from major depression and 15 healthy subjects. They were randomly divided into three groups: Group 1 (n=15): Patients who practiced Sahaj yoga meditation in addition to the conventional antidepressant medication. Group 2 (n=15): Patients received only antidepressant medication. Group 3 (n=15): Healthy subjects, who practiced Sahaj yoga. Group 1 and Group 3 subjects practiced Sahaj yoga meditation under the supervision of a trained Sahaj Yogi for a period of 8 weeks. All the subjects were assessed for pulse rate (PR), respiratory rate (RR), galvanic skin response (GSR) at 0 week (Pre-test) and 8 weeks (Post-test). After 8 weeks of intervention, there was statistically significant decrease in PR (p<0.001), RR (p<0.001) & GSR (p<0.001) in healthy subjects whereas, there was no significant change in these parameters in Group 1 subjects. Present study demonstrates beneficial effects of Sahaj yoga meditation on autonomic parameters in healthy subjects, but not in patients of major depression.
Article
Ninety-two prenatally depressed women were randomly assigned to yoga or a social support control group at 22 weeks gestation. The yoga group participated in a 20-minute group session (only physical poses) once per week for 12 weeks. The social support group (a leaderless discussion group) met on the same schedule. At the end of the first and last sessions, the yoga group as compared to the social support group reported less depression, anxiety, anger, back and leg pain, unlike the support group who did not show immediate effects. At the end of the treatment period, the yoga group and the support group did not differ and they both had lower summary depression (CES-D) scores, as well as lower negative effect and somatic/vegetative symptoms subscale scores on the CES-D and lower scores on the other depression measures (EPDS and POMS), lower anxiety (STAI) scores, lower anger (STAXI) scores and improved relationship quality scores. In addition, cortisol levels decreased for both groups after the sessions and at the end of the treatment period. Estriol and progesterone levels increased across the treatment period and decreased after the last session for both groups. Depression and anxiety levels also decreased for both groups at the postpartum period. Thus, this study suggests that yoga as compared to social support sessions may have greater immediate effects on depression, anger, back and leg pain, but that both yoga and social support had positive effects on depressed pregnant women over the longer term.
Article
There are 2 families of statistical procedures in meta-analysis: fixed- and random-effects procedures. They were developed for somewhat different inference goals: making inferences about the effect parameters in the studies that have been observed versus making inferences about the distribution of effect parameters in a population of studies from a random sample of studies. The authors evaluate the performance of confidence intervals and hypothesis tests when each type of statistical procedure is used for each type of inference and confirm that each procedure is best for making the kind of inference for which it was designed. Conditionally random-effects procedures (a hybrid type) are shown to have properties in between those of fixed- and random-effects procedures.
Article
Objective. —To determine if inadequate approaches to randomized controlled trial design and execution are associated with evidence of bias in estimating treatment effects. Design. —An observational study in which we assessed the methodological quality of 250 controlled trials from 33 meta-analyses and then analyzed, using multiple logistic regression models, the associations between those assessments and estimated treatment effects. Data Sources. —Meta-analyses from the Cochrane Pregnancy and Childbirth Database. Main Outcome Measures. —The associations between estimates of treatment effects and inadequate allocation concealment, exclusions after randomization, and lack of double-blinding. Results. —Compared with trials in which authors reported adequately concealed treatment allocation, trials in which concealment was either inadequate or unclear (did not report or incompletely reported a concealment approach) yielded larger estimates of treatment effects ( P P =.01), with odds ratios being exaggerated by 17%. Conclusions. —This study provides empirical evidence that inadequate methodological approaches in controlled trials, particularly those representing poor allocation concealment, are associated with bias. Readers of trial reports should be wary of these pitfalls, and investigators must improve their design, execution, and reporting of trials. ( JAMA . 1995;273:408-412)
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The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
Article
Objective. —To determine if different mental disorders commonly seen in primary care are uniquely associated with distinctive patterns of impairment in the components of health-related quality of life (HRQL) and how this compares with the impairment seen in common medical disorders.Design. —Survey.Setting. —Four primary care clinics.Subjects. —A total of 1000 adult patients (369 selected by convenience and 631 selected by site-specific methods to avoid sampling bias) assessed by 31 primary care physicians using PRIME-MD (Primary Care Evaluation of Mental Disorders) to make diagnoses of mood, anxiety, alcohol, somatoform, and eating disorders.Main Outcome Measures. —The six scales of the Short-Form General Health Survey and self-reported disability days, adjusting for demographic variables as well as psychiatric and medical comorbidity.Results. —Mood, anxiety, somatoform, and eating disorders were associated with substantial impairment in HRQL. Impairment was also present in patients who only had subthreshold mental disorder diagnoses, such as minor depression and anxiety disorder not otherwise specified. Mental disorders, particularly mood disorders, accounted for considerably more of the impairment on all domains of HRQL than did common medical disorders. Finally, we found marked differences in the pattern of impairment among different groups of mental disorders just as others have reported unique patterns associated with different medical disorders. Whereas mood disorders had a pervasive effect on all domains of HRQL, anxiety, somatoform, and eating disorders affected only selected domains.Conclusions. —Mental disorders commonly seen in primary care are not only associated with more impairment in HRQL than common medical disorders, but also have distinct patterns of impairment. Primary care directed at improving HRQL needs to focus on the recognition and treatment of common mental disorders. Outcomes studies of mental disorders in both primary care and psychiatric settings should include multidimensional measures of HRQL.(JAMA. 1995;274:1511-1517)
Article
Background: So-called 'third wave' cognitive and behavioural therapies represent a new generation of psychological therapies that are increasingly being used in the treatment of psychological problems. However, the effectiveness and acceptability of third-wave cognitive and behavioural therapy (CBT) approaches as treatment for acute depression remain unclear. Objectives: 1. To examine the effects of all third wave CBT approaches compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.2. To examine the effects of different third wave CBT approaches (ACT, compassionate mind training, functional analytic psychotherapy, dialectical behaviour therapy, MBCT, extended behavioural activation and metacognitive therapy) compared with treatment as usual/waiting list/attention placebo/psychological placebo control conditions for acute depression.3. To examine the effects of all third wave CBT approaches compared with different types of comparators (treatment as usual, no treatment, waiting list, attention placebo, psychological placebo) for acute depression. Search methods: We searched the Cochrane Depression Anxiety and Neurosis Group Trials Specialised Register (CCDANCTR to 01/01/12), which includes relevant randomised controlled trials from The Cochrane Library (all years), EMBASE, (1974-), MEDLINE (1950-) and PsycINFO (1967-). We also searched CINAHL (May 2010) and PSYNDEX (June 2010) and reference lists of the included studies and relevant reviews for additional published and unpublished studies. An updated search of CCDANCTR restricted to search terms relevant to third wave CBT therapies was conducted in March 2013 (CCDANCTR to 01/02/13). Selection criteria: Randomised controlled trials that compared third wave CBT therapies with control conditions for acute depression in adults. Data collection and analysis: Two review authors independently identified studies, assessed trial quality and extracted data. Study authors were contacted for additional information when required. We rated the quality of evidence using GRADE methods. Main results: Four small studies (224 participants) were included in the review. Little information was provided about the process of allocating participants to groups. None of the studies used independent outcome assessors, and evidence suggested researcher allegiance towards the active treatments. The four studies examined a diversity of third wave CBT approaches (extended behavioural activation, acceptance and commitment therapy and competitive memory training) and control conditions. None of the studies conducted follow-up assessments. The results showed a significant difference in clinical response rates in favour of third wave CBT when compared with treatment as usual (TAU) conditions (three studies, 170 participants, risk ratio (RR) 0.51, 95% confidence interval (CI) 0.27 to 0.95; very low quality). No significant difference in treatment acceptability based on dropout rates was found between third wave CBT approaches and TAU (four studies, 224 participants, RR 1.01, 95% CI 0.08 to 12.30; very low quality). Both analyses showed substantial statistical heterogeneity. Authors' conclusions: Very low quality evidence suggests that third wave CBT approaches appear to be more effective than treatment as usual in the treatment of acute depression. The very small number of available studies and the diverse types of interventions and control comparators, together with methodological limitations, limit the ability to draw any conclusions on their effect in the short term or over a longer term. The increasing popularity of third wave CBT approaches in clinical practice underscores the importance of completing further studies of third wave CBT approaches in the treatment of acute depression, on a short- and long-term basis, to provide evidence of their effectiveness to policy-makers, clinicians and users of services.
Article
The purpose of this study was to compare the effects of yoga (physical activity) versus social support (verbal activity) on prenatal and postpartum depression. Ninety-two prenatally depressed women were randomly assigned to a yoga or a social support control group at 22 weeks gestation. The yoga group participated in a 20-min group session (only physical poses) once per week for 12 weeks. The social support group (a leaderless discussion group) met on the same schedule. At the end of the first and last sessions the yoga group reported less depression, anxiety, anger, back and leg pain as compared to the social support group. At the end of the last session the yoga group and the support group did not differ. They both had lower depression (CES-D), anxiety (STAI), and anger (STAXI) scores and improved relationship scores. In addition, cortisol levels decreased for both groups following each session. Estriol and progesterone levels decreased after the last session. At the postpartum follow-up assessment depression and anxiety levels were lower for both groups.
Article
Women are approximately twice as likely to experience depression compared to men and are at significantly greater risk for developing comorbid physical health conditions, including diabetes, chronic inflammatory diseases, and cardiovascular disease, suggesting a possible common mechanism for the psychological and physical health risks seen in depression. We examined one biological pathway that may underlie these effects by investigating the extent to which HPA axis activity was dysregulated in 26 women with current major depression and 23 age- and BMI-matched psychiatrically healthy women. Salivary cortisol samples were collected at wakening, 30 min later, and at bedtime over three consecutive days. Depressed women exhibited flatter diurnal cortisol slopes compared to non-depressed women (F2 = 5.52, p = .004). To investigate whether these differences could be attributed to differences in glucocorticoid feedback sensitivity, saliva samples were also collected on a fourth consecutive day after participants self-administered dexamethasone. Analyses revealed that depressed women exhibited a dampened response to dexamethasone compared to non-depressed women (F1 = 6.04, p = .015). These findings are consistent with previous studies showing that depression is associated with altered HPA axis regulation, but extend this work by showing that reduced hypothalamic and pituitary sensitivity to negative feedback from glucocorticoids is one mechanism that may explain this effect. Altered glucocorticoid sensitivity may play a role in promoting depression as well as the physical health complications that frequently co-occur with this serious psychiatric disorder.
Article
Mindfulness meditation-based therapies are being increasingly used as interventions for psychiatric disorders. Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have been studied extensively. MBSR is beneficial for general psychological health and pain management. MBCT is recommended as an adjunctive treatment for unipolar depression. Both MBSR and MBCT have efficacy for anxiety symptoms. Informed clinicians can do much to support their patients who are receiving mindfulness training. This review provides information needed by clinicians to help patients maximize the benefits of mindfulness training and develop an enduring meditation practice.
Book
The Cochrane Handbook for Systematic Reviews of Interventions (the Handbook) has undergone a substantial update, and Version 5 of the Handbook is now available online at www.cochrane-handbook.org and in RevMan 5. In addition, for the first time, the Handbook will soon be available as a printed volume, published by Wiley-Blackwell. We are anticipating release of this at the Colloquium in Freiburg. Version 5 of the Handbook describes the new methods available in RevMan 5, as well as containing extensive guidance on all aspects of Cochrane review methodology. It has a new structure, with 22 chapters divided into three parts. Part 1, relevant to all reviews, introduces Cochrane reviews, covering their planning and preparation, and their maintenance and updating, and ends with a guide to the contents of a Cochrane protocol and review. Part 2, relevant to all reviews, provides general methodological guidance on preparing reviews, covering question development, eligibility criteria, searching, collecting data, within-study bias (including completion of the Risk of Bias table), analysing data, reporting bias, presenting and interpreting results (including Summary of Findings tables). Part 3 addresses special topics that will be relevant to some, but not all, reviews, including particular considerations in addressing adverse effects, meta-analysis with non-standard study designs and using individual participant data. This part has new chapters on incorporating economic evaluations, non-randomized studies, qualitative research, patient-reported outcomes in reviews, prospective meta-analysis, reviews in health promotion and public health, and the new review type of overviews of reviews.
Article
Objectives: To systematically review and meta-analyze the effectiveness of yoga for low back pain. Methods: MEDLINE, the Cochrane Library, EMBASE, CAMBASE, and PsycINFO, were screened through January 2012. Randomized controlled trials comparing yoga to control conditions in patients with low back pain were included. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Main outcome measures were pain, back-specific disability, generic disability, health-related quality of life, and global improvement. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Results: Ten randomized controlled trials with a total of 967 chronic low back pain patients were included. Eight studies had low risk of bias. There was strong evidence for short-term effects on pain (SMD=-0.48; 95% CI, -0.65 to -0.31; P<0.01), back-specific disability (SMD=-0.59; 95% CI, -0.87 to -0.30; P<0.01), and global improvement (risk ratio=3.27; 95% CI, 1.89-5.66; P<0.01). There was strong evidence for a long-term effect on pain (SMD=-0.33; 95% CI, -0.59 to -0.07; P=0.01) and moderate evidence for a long-term effect on back-specific disability (SMD=-0.35; 95% CI, -0.55 to -0.15; P<0.01). There was no evidence for either short-term or long-term effects on health-related quality of life. Yoga was not associated with serious adverse events. Discussion: This systematic review found strong evidence for short-term effectiveness and moderate evidence for long-term effectiveness of yoga for chronic low back pain in the most important patient-centered outcomes. Yoga can be recommended as an additional therapy to chronic low back pain patients.