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Kochupillai, V., Kumar, P., Singh, D., Aggarwal, D., Bhardwaj, N., Bhutani, M., DAS, S.N. (2005) Effect of rhythmic breathing (sudarshan kriya and pranayam) on immune functions and tobacco addiction.
Annals of the New York Academy of Sciences
Abstract
Effect of rhythmic breathing (sudarshan kriya and pranayam) on immune functions and tobacco addiction. Ann N Y Acad Sci. 1056:242-52. Stress affects different systems in the body, including the immune system and the endocrine system, and thereby affects the whole physiology. Stress is also linked to the habit of tobacco consumption and substance abuse, which in turn leads to disease states. Previous research has suggested that Sudarshan Kriya (SK) and Pranayama (P), rhythmic breathing processes derived from yoga, reduce stress and improve immune functions. In this study, the possible affect of SK&P on natural killer (NK) cells, a critical cell type in the immune system which helps fight pathogens and cancer, was assessed in cancer patients who completed their standard therapy. SK&P practice correlated with increases in NK cell numbers, but not in the number of other immune cells. Furthermore, SK&P helped to reduce tobacco use in 21% of the individuals at 6 months of practice. Larger and randomized studies are needed, but these findings suggest that SK&P may help boost the immune system in cancer patients.
Supplementary resource (1)
Data
July 2014
... It has also been associated with a reduction in anxiety and depression (Sharma et al., 2015). The practice has also been shown to positively affect cardiac autonomic tone (Kharya et al. 2014), brain waves (Chandra et al., 2017), immunity by increasing the number of natural killer cells (Kochupillai et al., 2005), antioxidant status, and gene expression (Sharma et al., 2003;Sharma et al, 2008). ...
... Furthermore, incorporation of respiratory practices alongside tobacco use exhibited a 21% success rate in terms of achieving control over a period of up to six months of observation. (Kochupillai et al., 2005) The World Health Organization (WHO) has identi ed stress as a contributing factor to many diseases that can be classi ed as "diseases of civilization" (Prüss-Ustün et al., WHO 2016). Considering the current global mental health crisis and the numerous obstacles that make it di cult to access psychotherapy, there is an urgent need for easily accessible and implementable methods such as breath work. ...
... Our analysis demonstrates that IBP therapy reduces the level of immunosuppressive cortisol (reducing stress) and increases the level of prolactin, which supports the endocrine and immune systems, stimulates the proliferation and activation of immune cells, increases antibody production, and acts in opposition to cortisol. Regular breathwork exercises have been shown to enhance NK cell activity (Kamei et al, 2001, Kochupillai, 2005, thus bolstering the immune system's anticancer response. Furthermore, alterations in the tumor microenvironment, such as elevated blood pH and reduced acidity, can impede tumor cell proliferation and enhance response to therapy. ...
Abstract
Introduction
Stress and negative emotions have been demonstrated to exert a substantial impact on cancer patients, affecting their ability to adapt to therapy and the treatment's overall effectiveness. Elevated cortisol levels, a stress-induced hormone, have been shown to suppress immune system function, potentially reducing the body's capacity to combat cancer cells. Conversely, prolactin, a hormone that stimulates the immune system, has demonstrated potential in this context but requires further study.
Goal
The objective of this study was to investigate the physiological changes that occur during the Conscious Connected Breathing (CCB) session, as part of a larger study. The main objective was to create a new form of integrative psychosomatic intervention, called Integrative Breathwork Psychotherapy (IBP), suitable for cancer patients that would improve both their psychosomatic and immune status.
Method
Of all eligible consecutive breast cancer patients hospitalised for post-operative radiotherapy who were invited to participate in the study, 77 patients took part in the study (experimental group – 48 pts, controls – 29 pts, response rate: 62%). IBP had a small open group setting (up to six participants). It included ten sessions in a small open group setting, three meetings a week. Each meeting consisted of a 45-minute breathwork session (CCB – rhythmic circular breathing through the nose, deeper than usual, without breath holding) in the state of acceptance followed by free emotional expression. Patients were encouraged to exercise 15 minutes daily on the other days of the week and after the programme was completed.
The factors analysed were white blood cells, lymphocyte counts, IgA, serum prolactin and cortisol concentration, arterialised capillary blood gasometry. IgA, hormone and gasometry measures were taken before the 10th session and after 30 min (2/3 of the session) when the patients gained experience and practised correctly.
Results
During the CCB session, the gasometry showed significant change indicating slight overbreathing pattern, including decreases in pCO2 (P=0.003), pO2 (P<0.001), CH+ (P<0.001), ctO2 (P<0.001), COHb (P=0.03), and HHb (P=0.004) alongside an increase in pH (P<0.001). Additionally, prolactin level increased (P<0.001), while cortisol (P<0.001) and IgA (P<0.001) decreased.
Conclusion
This study is the first to analyze changes in capillary blood gas levels and hormonal balance during Conscious Connected Breathing sessions, revealing its immunostimulatory effects. The observed improvements in endocrine, immune, and respiratory-circulatory functions suggest breathwork could be a valuable complementary therapy for cancer patients. Further research is needed to explore the mechanisms involved and assess long-term psychological and immunological impacts.
... A number of RCTs demonstrate the efficacy of yoga in regulating inflammatory markers. Ujjāyi and Bhastrika practices has been found to lower blood lactate levels, enhance antioxidant defence [53] and improve Natural Killer (NK) cell counts [54]. Also, studies have reported that practice of yoga for 4 to 12 weeks can improve anti-oxidant status of an individual by improving the levels of glutathione and superoxide dismutase [55][56]. ...
... Yogic practices (particularly prānayāma and meditation) have exhibited significant immunomodulatory effects such as increase in production of immunoglobulins, activation of phagocytic functions and enhancement in humoral as well as cell-mediated immunity [49][50][51]54]. Further, they have been found to reduce inflammatory cytokines such as IL-6, IL-1b, TNF-a which are part of the 'cytokine storm' reported in COVID-19. ...
The COVID-19 pandemic has posed an immense challenge to health care systems around the globe in terms of limited health care facilities and proven medical therapeutics to address the symptoms of the infection. The current health care strategies have primarily focused on either the pathogen on the environmental factors. However, efforts towards strengthening the host immunity are important from public health perspective to prevent the spread of infection and downregulate the potency of the agent. While a vaccine can induce specific immunity in the host, non-specific ways of improving overall host immunity are the need. This scenario has paved the way for the use of traditional Indian therapies such as Ayurveda and Yoga. This review aims at collating available evidence on Ayurveda, Yoga and COVID-19. Further, it draws inferences from recent studies on Yoga and Ayurveda on immunity, respiratory health and mental health respectively to approximate its probable role in prophylaxis and as an add-on management option for the current pandemic.
... Yoga (rhythmic breathing part) helps in improving the immune system and body defence systems. [8] It also helps in wound healing by reducing the mediators of inflammatory response. [9] All these effects also helps in the maintenance of healthy gingival. ...
... [21,22] Yoga (rhythmic breathing) helpful in improving the immune system and body defense systems. [8] Since yoga involves body-mind relaxation techniques (pranayama and meditation) along with mild to moderate physical exercise (Asana), it was hypothesized that practice of yoga may optimize the production of the pro-inflammatory cytokines.. It also helps in wound healing by reducing the mediators of inflammatory response [9] . ...
This paper highlighting the benefits of yoga (rhythmic breathing exercises) in the maintenance of oral hygiene and gingival bleeding. This is a two group comparative study. The participants of group A was practicing yoga for about 30 minutes and the participants of group B did not practice yoga. The study is carried out with three parameters, Debris index, Calculus index and Gingival bleeding index. These parameters were compared over the group B. The unpaired t-test was carried out to compare the two groups. The results showed that the group A has significantly lower debris and calculus value. The debris index have P<0.01 and calculus index have p< 0.001, the oral hygiene index has the p< 0.001, which is significant. The average value of gingival bleeding index of group A is less than the group B. So the yoga is helpful in maintenance of oral hygiene and gum bleeding.
... Sudarshan kriya Yoga (SKY), designed by Sri Sri Ravi Shankar, is a rhythmic breathing exercise, is very effective in these contexts. SKY is composed of Ujjayi Pranayama, Bhastrika Pranayama and brief chanting, which is done in sitting posture and closed eye [15]. Benefits includes reduction in stress, anxiety and depression, posttraumatic stress disorder, substance abuse, improve antioxidant status etc. [16,17]. ...
... All subjects were instructed not to take any medication, antioxidant supplements or any other citrus fruits, which could interferes with study results. Orange consuming group students were instructed to take 200 ml of orange juice (freshly prepared), after breakfast and Sudarshan kriya performing group students were instructed to perform the yoga regularly for one month in the morning time for 30 minutes [15,18]. Before and after the experiment, STAI values (Spielbergers STAI questionnaire) calculated and differential count (Leishman's staining) was done [19]. ...
... Several studies have suggested a correlation between the practice of yogic breathing and the modulation of hormone levels, inflammatory markers, and various cytokines involved in immunity (Balasubramanian et al., 2015;Kochupillai et al., 2005;Twal et al., 2016;Venkatesh et al., 2020). Furthermore, oncology patients practicing yogic breathing and mindfulness have reported improvements in symptom burden associated with cancer and chemotherapy, including decreased nausea and pain levels (Lee et al., 2023). ...
... It has been found to significantly improve physical and psychosocial domains and the quality of life in patients with diabetes [21,22]. Previous studies suggest that SKY is useful for relieving depression [23,24] and improving antioxidant and immune defenses of the body [25]. ...
Introduction
One of the major health problems in many countries including India is type 2 diabetes. Yoga is being explored as an alternative therapy for the management of diabetes.
Methods
Among the total of 137 participants who successfully completed the ‘Living Well’ workshop by the Art of Living, 84 with type 2 diabetes were assessed for change in random blood sugar levels, systolic and diastolic blood pressure levels (SBP/DBP), and pulse rate over seven days. In the Living Well workshop, the participants performed a comprehensive Yogic Breathing Program that included yogic movements and postures (Asana), relaxation practice, three-stage Pranayama, Sudarshan Kriya Yoga (SKY), breathing techniques, and discussion of stress relieving principles over those seven days. The parameters were recorded at the time of enrollment and after the completion of seven days of the workshop.
Results
There was a greater (p<0.05) percent reduction in the mean blood sugar level in diabetics as compared to non-diabetic individuals. However, the reduction in SBP and DBP were similar (p>0.05) in diabetics and non-diabetics. The percent reduction in the pulse rate however was greater (p<0.05) in diabetics than non-diabetics.
Conclusion
Comprehensive yogic breathing practices comprising SKY may be beneficial in patients with type 2 diabetes mellitus.
... (Zope, 2013). Estas técnicas, que pueden ser enseñadas en pocos días a grandes grupos por un costo mínimo, aparte de los ya conocidos beneficios contra la ansiedad y la depresión (Toschi-Dias, 2017) (Hamilton, 2019), también mejoran el sistema inmunológico (Kochupillai, 2005), promueven el equilibrio endocrino (Shiju, 2019), previenen el estrés oxidativo y hasta se han recopilado datos que muestran que retarda el envejecimiento. El Programa Prison lleva estos cursos y técnicas, especialmente el Sudarshan Kriya, a las cárceles por medio de voluntarios, tanto instructores como practicantes avanzados que actúan como soporte. ...
Existen testimonios que relatan los beneficios de la práctica del Yoga y la Meditación en las cárceles, tanto de presos que han accedido a estos programas, como así también de funcionarios y colaboradores de las prisiones, pero es difícil cuantificar el verdadero impacto de estas técnicas en el bienestar y la conducta de los internos, por un lado, por las dinámicas propias del sistema penitenciario y, por otro lado, porque muchos de esos efectos son subjetivos e intangibles. Me propuse en este artículo analizar críticamente la literatura relevante que estudia diversos proyectos de Yoga y Meditación en cárceles en distintas partes del mundo. Aunque es necesaria más investigación, sobre todo interdisciplinaria, hay en dichos estudios evidencias de la viabilidad de los Programas de Yoga y Meditación en las cárceles, de su ventajosa relación costo-beneficio, de su papel en bajar los índices de reincidencia y de los múltiples efectos positivos de dichos proyectos en el ambiente carcelario y social.
... A study in India used Sudarshan Kriya (SK) and pranayama (P) pranayamas are slow yogic breathing techniques aimed at achieving mastery over the breath and mind) in patients with nicotine dependence with cancer after they had completed standard therapy. The authors reported that SK and P helped to control the habit of tobacco consumption in 21 percent of individuals (Kochupillai et al., 2005). In a randomized controlled trial at NIMHANS, 60 patients with alcohol dependence admitted for detoxification were randomized into SK or treatment as usual (TAU) groups. ...
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.
... The authors concluded that through practicing breathing techniques, individuals can voluntarily control their autonomic nervous as well as the immune system. Kochupillai et al. (2005) evaluated the effectiveness of Sudarshan Kriya and Pranayam rhythmic breathing processes on immune functions. It was found that both breathing techniques significantly increased participants' natural killer cells. ...
Breathing, although unconscious and often overlooked, is a central aspect of our whole being and one of our most vital functions. This review paper aims at investigating the physiological as well as the neuropsychological benefits of breathing training techniques. In addition, we examine the effectiveness of mobile breathing applications in upgrading human health and wellness. Finally, we discuss the role of metacognition in breathing, as the only means people have to gain awareness of the profound powers of breath and take conscious control of their health.
... Many European and Asian countries have faced a second wave of the pandemic while India is experiencing the second wave at present The COVID- 19 damages the respiratory tract, obstructing airflow. 1 It triggers asthma attacks and causes acute respiratory distress syndrome (ARDS). 2 Deep breathing exercises that clear the lungs and strengthen lung function may be especially beneficial for people with these conditions. 3,4 Evidence indicates that breathing exercises improve lung functions, 5,6 boost immunity, 7 and manages stress. 8 However, the effect of breathing exercise on COVID-19 infection is not yet established. ...
Introduction: The present study assessed the prevalence of COVID-19 among people practicing three-step rhythmic breathing (3SRB) exercise and those who were not practicing any breathing exercises, including 3SRB exercise.
Methods: A community-based cross-sectional observational study was conducted. Data was collected using a self-constructed online google survey tool from July 2020 to August 2020.
Results: Out of a total 1083 sample, a higher proportion of the participants (41.3%) belonged to the 34-49 years age group, followed by the age group of 50-65 (32.5%). The sample was almost equally distributed; about 51.9% of the population was male, and 48.4% were female. The COVID-19 positivity was recorded almost double (3.1%) in groups not practicing 3SRB exercises compared to a group (1.3%) practicing 3SRB exercises. Furthermore, the practice of 3SRB was significantly associated with a lower percentage of COVID-19 infection (p=0.046).
Conclusions: Practice of 3SRB is significantly associated with a lower percentage of COVID-19 infection. A future study with a robust methodology is warranted to validate the findings of this study and determine the effects of 3SRB on physiological and biological markers.
... 40 Rhythmic breathing processes are known to reduce stress and improve immune functions. 41 Four of the studies reviewed mentioned stress reduction and mood enhancement as a finding compared to controls. 23,24,29,30 Limitations This review has several limitations. ...
It has been suggested that yoga may be an effective adjunct intervention in the management of substance use disorders (SUD). Additionally, women with SUD require different treatment approaches than men. The objective of this study was to critically evaluate the evidence for the effectiveness of yoga, specifically for women, as part of treatment for SUD. Nine electronic databases were searched from inception to January 2020. Randomized controlled trials (RCT) that evaluated any type of yoga, including yoga as a component of mindfulness-based treatment, against any type of control in individuals with any type of addiction were eligible. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Statement, methodological quality was appraised using Physiotherapy Evidence Database (PE Dro) criteria. Ten RC Ts (eight mixed-gender and two female-focused) met the eligibility criteria. Most of these RCTs were small to medium-sized, with various methodological and analytical flaws and deficits. The types of addictions included in these studies were alcohol, drug, and nicotine addiction. Most RCTs suggested that various types of yoga, primarily Hatha Yoga and its components, led to favorable or equivalent results for SUD as an adjunct to control or treatment-as-usual interventions. There are limited results on the impact of yoga for SUD specifically focused on women and their unique needs. Although the results of mixed-gender articles are encouraging, large RCTs with gender-specific subanalyses are required to better determine the benefits specific to women incorporating yoga for SUD.
... Structured yoga has also shown to decrease IL-6, TNF alpha, and IL-1 beta 3 production and ultimately reduces inflammation[17][18][19] , an immune enhancing response against COVID-19 inside the body. Furthermore, the guidelines consists of immune-modulating medicinal herbs such as Tinospora cordifolia Linn., Glycyrhiza glabra, Piper longum, Zingiber officinalis, Termenalia chebula, Emblica officinale; Withania somnifera, Cinnamomum zeylanicum as anti-oxidant; Ocimum sanctum, Allium sativum as antiviral agents; and Mentha arvensis, Cinnamomum tamala, Foeniculum vulgare as anti-inflammatory agents.A herbomineral combination of Tinospora cordifolia 21 (Gauche in sanskrit, Gurjo in Nepali), Trikatu; a mixture of equal proportion of fruits of Piper longum Linn. ...
BACKGROUND: World community is facing an unprecedented pandemic of
novel corona virus disease (COVID-19) caused by Severe
Acute Respiratory Syndrome Corona virus 2 (SARSCoV-2). The disease has spread globally with the case fatality
rate of 3% showing more than 47.6 million confirmed cases,
3.5 million recovered cases and 1.22 million deaths as of
November 5, 20201
.
Despite being a close neighbor country of China where the
outbreak first erupted, and India 185974 confirmed cases,
148408 recovered cases and 1052 deaths have been reported
by November 5, 2020 in Nepal where the case fatality rate
has been recorded 0.57 percent2
. Initially, 32 year old student
was the first case detected COVID 19 positive on January
25, 2020 who returned from the Wuhan University of
Technology, Hubei province, China on January 9, 2020 and
he was reported to be recovered3
. From March 23 to April
2, 2020, five new cases were detected after a two months
interval since the first case reported. All these cases were
history of foreign travelling. On April 4, 2020, three more
new cases we detected including one case of having local
transmission of infection. The case of local transmission
of COVID 19 was found in Kailali district, a Far western
province of Nepal. It was suspected to be transmission of
stage II as per the WHO guidelines
... A study in India used Sudarshan Kriya (SK) and pranayama (P) pranayamas are slow yogic breathing techniques aimed at achieving mastery over the breath and mind) in patients with nicotine dependence with cancer after they had completed standard therapy. The authors reported that SK and P helped to control the habit of tobacco consumption in 21 percent of individuals (Kochupillai et al., 2005). In a randomized controlled trial at NIMHANS, 60 patients with alcohol dependence admitted for detoxification were randomized into SK or treatment as usual (TAU) groups. ...
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.
... 95 Kochupillai et al reported increase in natural killer cells in cancer patients who had completed their standard therapy after practicing Sudarshan Kriya Yoga and pranayam breathing techniques. 96 A systematic review and meta-analysis of RCTs on the physical and psychosocial benefits of yoga in cancer patients and survivors by Buffart and colleagues concluded that yoga may be a feasible intervention as beneficial effects on several physical and psychosocial symptoms were reported. 97 They showed that it has strong beneficial effects on distress, anxiety and depression, moderate effects on fatigue, general HRQoL, emotional function and social function, small effects on functional well-being, and no significant effects on physical function and sleep disturbances. ...
... 95 Kochupillai et al reported increase in natural killer cells in cancer patients who had completed their standard therapy after practicing Sudarshan Kriya Yoga and pranayam breathing techniques. 96 A systematic review and meta-analysis of RCTs on the physical and psychosocial benefits of yoga in cancer patients and survivors by Buffart and colleagues concluded that yoga may be a feasible intervention as beneficial effects on several physical and psychosocial symptoms were reported. 97 They showed that it has strong beneficial effects on distress, anxiety and depression, moderate effects on fatigue, general HRQoL, emotional function and social function, small effects on functional well-being, and no significant effects on physical function and sleep disturbances. ...
Notes on Anatomy & Physiology for Yoga Education compiled and edited by Dr Ananda with assistance of Ramya Pillutla and Sri G Dayanidy at CYTER
... Stress management and moves to relieve stressful working conditions should be an integral part of any smoking/ drinking cessation programs. (27) A literature browse also shows significant reduction in addictive behaviour after SK. (28)(29)(30) Although consumption of alcohol, tobacco and cigar was low in both the groups, a uniform distribution of improvement is seen in controls. In subjects doing regular SK, a sharp rise in the number of people showing improved scores strongly suggests a good control on such habits, as is also indicated by a significant p-value (p=0.00) for Pearson's Chi-square (df= 5)= 22.92 obtained here. ...
... One of the reasons could be that it is cost-effective and also emphasis on prevention of disease. [2] Till date, few researches in the past have been attempted to evaluate the effect of complementary and alternative medicine (CAM) in the management of periodontitis. ...
... One of the reasons could be that it is cost-effective and also emphasis on prevention of disease. [2] Till date, few researches in the past have been attempted to evaluate the effect of complementary and alternative medicine (CAM) in the management of periodontitis. ...
Background: Yogic stretching (asana) has been proven to have an effect on salivary human
beta‑defensin‑2 (HBD‑2) concentration, which is an antimicrobial peptide and is an inflammatory marker in periodontal disease. Sudarshan Kriya Pranayama (SKP) is a part of yoga which involves rhythmic breathing. Hence, we aim to evaluate the periodontal parameters and to estimate the salivary HBD‑2 level before and after SKP program in periodontitis individuals.
Materials and Methods: An interventional study was designed and individuals were divided into three groups: Group I – healthy periodontium, Group II – chronic gingivitis, and Group III – chronic periodontitis. SKP was the interventional tool. The clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and salivary HBD‑2 level were analyzed at baseline and 90 days after the SKP practice. Enzyme‑linked immunosorbent assay (ELISA) was used to evaluate salivary HBD‑2. McNemar’s Chi‑square, Paired samples t‑test, and one‑way ANOVA were used to analyze the results. P < 0.05 was considered statistically significant.
Results: Following the SKP intervention, the clinical parameters such as PI and GI improved
significantly in all the groups (P < 0.001); however, Group III showed a significant reduction as compared to the other groups. The mean baseline salivary HBD‑2 levels of Group I, Group II, and Group III were 91.78 ng/μl, 110.22 ng/μl, and 157.63 ng/μl which was further decreased to 95.22 ng/μl, 98.22 ng/μl, and 132.88 ng/μl, respectively, following SKP intervention (P < 0.001). However, Group III had a higher HBD‑2 level at 90th day as compared to other groups.
Conclusion: There was an improvement in PI and GI with a decrease in salivary HBD‑2 in chronic periodontitis patients following SKP. Hence, SKP can be considered as an adjunct to treatment modality in patients with periodontal disease.
... SK is preceded by Ujjayi pranayama and Bhastrika Pranayama. Details are provided in earlier publications 7,8,12 . Subjects with cardiac illness, hypertension, diabetes, epilepsy, respiratory disorders, neurological and mental diseases, depression, and dependency on drugs other than tobacco and alcohol were excluded from the study. ...
Adolescence is a critical life period that marks the transition into adulthood. This novel study aims to evaluate the benefits of 4- day intervention, Sudarshan Kriya Yoga (SKY), a breathing technique, on the emotional, mental, and cognitive health of teenagers. Open label trial tests were administered at pre-intervention, immediately after SKY, and after 40 days of SKY practice. Cognitive abilities of 275 adolescents were tested using the Six letter cancellation test. Mental well-being was assessed using the World Health Organization-five Index (WHO-5), and Emotional well-being using the Strength and Difficulty Questionnaire (SDQ) questionnaire. The Results were analyzed using a paired-sample t test. The results showed an improvement in cognitive abilities for 71% of the study population as measured by the six-letter cancellation test, better mental health scores for 86%, and better SDQ scores for 95% of the population after SKY practice.
Background:
Integrative oncology combines conventional and complementary, or integrative, therapies for a holistic treatment of cancer patients. Yoga is increasingly used as a complementary therapy for cancer patients, but there is no direct evidence for its effect on cancer pathophysiology like tumor response, or patient outcome like overall survival.
Summary:
In this narrative review, we present in detail published studies from randomized clinical trials on complementary yoga therapy for cancer patients, including details about the biochemical mechanisms involved. Medicinal hatha yoga with breathing, postures, meditation, and relaxation enhances the quality of life of cancer patients by providing both psychological and physiological health benefits, highlighting the interconnectedness of mind and body. Yoga therapy reduces stress levels improving heart rate variability, leading to changes in hormonal regulation (e.g. cortisol), reduced oxidative stress and improved immune function with reduced inflammation. Still, the biochemical effects of yoga on the cancer disease itself are unrevealed.
Key messages:
More clinical and basic research is needed for further establishment of yoga as complementary therapy in oncology.
Introduction
Over one‐third of US adolescents engage in health risk and problem behaviors. Additionally, significant percentages of problem‐free youth aren't flourishing. Left unaddressed, the lifetime mental/physical health and financial burdens may be substantial. Social‐Emotional Learning (SEL) and Positive Youth Development (PYD) programs have proliferated to address the drivers of adaptive versus risk behaviors. Research suggests SEL/PYD program outcomes can be improved by adding techniques that physiologically induce calmness, yet few studies exist.
Methods
This randomized controlled trial of 79 urban eighth‐graders examined a standardized bio‐psycho‐social program, SKY Schools, which incorporates a physiologically calming component: controlled yogic breathing.
Results
Repeated‐measures ANOVAs demonstrated that compared to controls, SKY graduates exhibited significant improvements in emotion regulation, planning and concentration, and distractibility. After 3 months, significant improvements were evidenced in emotion regulation, planning and concentration, identity formation, and aggressive normative beliefs.
Conclusion
SEL/PYD programs may benefit by incorporating biologically‐calming techniques to enhance well‐being and prevent risk/problem behaviors.
Background
India has nearly 267 million adult tobacco users, with a slowly improving quitting rate. Among the many approaches to quitting the habit, such as counseling, nicotine replacement therapy, nicotine patch or gum, and prescribed allopathic medicines. Complementary and alternative medicine/therapy (CAM), a thousand-year-old practice in India, may also prove to be a potential method in tobacco cessation; however, there is scarce literature on the extent of use of CAM among tobacco users who attempt to quit the habit. Therefore, this study attempts to examine the potential of CAM as a strategy for tobacco control in India.
Material and Methods
We undertook a secondary analysis of the data from both rounds of the Global Adult Tobacco Survey (GATS 2009 and 2016). The dependent variable included in the analysis was the use of traditional medicine as a method for quitting tobacco in three types of users—smokers, smokeless tobacco users, and dual users. The prevalence of CAM use was reported, and Chi-square test was applied to find the factors significantly associated with the use of CAM among tobacco users considering a P value of 0.05 to be statistically significant.
Results
The overall prevalence of traditional medicine use for GATS-1 was observed to be more among dual users (4%), while for GATS-2, it was highest among smokers (3%). For both rounds of the GATS survey, the use of traditional medicine was found to be higher among males, rural residents, users with no education or less than primary education, and the eastern region.
Conclusions
CAM has a promising potential for supporting tobacco cessation provided a concerted effort is undertaken to standardize pharmacopeia and establish robust clinical evidence. In addition, there is a need to create awareness, build the capacity of healthcare providers, and foster academic-industrial research in indigenous Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) systems.
Opioid use disorder (OUD) is widely prevalent in the United States and there are high levels of comorbidity between OUD and mental illnesses, such as depression, anxiety, and posttraumatic stress disorder. Psychotherapy, in addition to medication-assisted therapy, are considered important components of long-term OUD treatment. Sudarshan Kriya Yoga (SKY) is a breathing-based mind-body intervention that has been demonstrated to have multiple physiological and psychological benefits. In the current study, participants (N = 8) recruited from a rural community were offered SKY in addition to treatment-as-usual. Physical and psychological well-being were measured using the Behavior and Symptom Identification Scale-24, Short Form-36, Perceived Stress Scale, and participant logs and journals. Of eight participants, seven (87.5%) successfully completed the SKY intervention. Compared to baseline, there was a significant decrease in substance use cravings (p = 0.04) and depression (p = 0.01). In addition, physical functioning and emotional well-being significantly increased after SKY. SKY demonstrated efficacy in improving physical and social functioning along with enhancing mental and emotional well-being. Larger-scale trials should be performed to validate these findings. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Exercise is well known to be beneficial to physical health; however, increasing research indicates that physical exercise is also beneficial to brain health and may alleviate symptoms of mental disorders. This book, written by international experts, describes and explores the theory and practice of exercise intervention for different mental disorders across the life span. Drawing on evidence from basic neuroscience research, and enriched with findings from the latest clinical trials, the work provides clear descriptions of current practice and highlights ways to translate this knowledge into pragmatic advice for use in daily practice. The chapters cover a broad range of conditions including neurodevelopmental disorders, depression, anxiety, psychosis and late life neurocognitive disorders. This book is for mental health clinicians including psychiatrists, psychologists, social workers, nurses, as well as internists, paediatricians and geriatricians seeking a comprehensive and individualized approach to treatment.
Background:
Mindfulness-based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. Types of mindfulness-based interventions include mindfulness training, which involves training in meditation; acceptance and commitment therapy (ACT); distress tolerance training; and yoga.
Objectives:
To assess the efficacy of mindfulness-based interventions for smoking cessation among people who smoke, and whether these interventions have an effect on mental health outcomes.
Search methods:
We searched the Cochrane Tobacco Addiction Group's specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, and trial registries to 15 April 2021. We also employed an automated search strategy, developed as part of the Human Behaviour Change Project, using Microsoft Academic.
Selection criteria:
We included randomised controlled trials (RCTs) and cluster-RCTs that compared a mindfulness-based intervention for smoking cessation with another smoking cessation programme or no treatment, and assessed smoking cessation at six months or longer. We excluded studies that solely recruited pregnant women.
Data collection and analysis:
We followed standard Cochrane methods. We measured smoking cessation at the longest time point, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of intervention and type of comparator. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. We summarised mental health outcomes narratively.
Main results:
We included 21 studies, with 8186 participants. Most recruited adults from the community, and the majority (15 studies) were conducted in the USA. We judged four of the studies to be at low risk of bias, nine at unclear risk, and eight at high risk. Mindfulness-based interventions varied considerably in design and content, as did comparators, therefore, we pooled small groups of relatively comparable studies. We did not detect a clear benefit or harm of mindfulness training interventions on quit rates compared with intensity-matched smoking cessation treatment (RR 0.99, 95% CI 0.67 to 1.46; I2 = 0%; 3 studies, 542 participants; low-certainty evidence), less intensive smoking cessation treatment (RR 1.19, 95% CI 0.65 to 2.19; I2 = 60%; 5 studies, 813 participants; very low-certainty evidence), or no treatment (RR 0.81, 95% CI 0.43 to 1.53; 1 study, 325 participants; low-certainty evidence). In each comparison, the 95% CI encompassed benefit (i.e. higher quit rates), harm (i.e. lower quit rates) and no difference. In one study of mindfulness-based relapse prevention, we did not detect a clear benefit or harm of the intervention over no treatment (RR 1.43, 95% CI 0.56 to 3.67; 86 participants; very low-certainty evidence). We did not detect a clear benefit or harm of ACT on quit rates compared with less intensive behavioural treatments, including nicotine replacement therapy alone (RR 1.27, 95% CI 0.53 to 3.02; 1 study, 102 participants; low-certainty evidence), brief advice (RR 1.27, 95% CI 0.59 to 2.75; 1 study, 144 participants; very low-certainty evidence), or less intensive ACT (RR 1.00, 95% CI 0.50 to 2.01; 1 study, 100 participants; low-certainty evidence). There was a high level of heterogeneity (I2 = 82%) across studies comparing ACT with intensity-matched smoking cessation treatments, meaning it was not appropriate to report a pooled result. We did not detect a clear benefit or harm of distress tolerance training on quit rates compared with intensity-matched smoking cessation treatment (RR 0.87, 95% CI 0.26 to 2.98; 1 study, 69 participants; low-certainty evidence) or less intensive smoking cessation treatment (RR 1.63, 95% CI 0.33 to 8.08; 1 study, 49 participants; low-certainty evidence). We did not detect a clear benefit or harm of yoga on quit rates compared with intensity-matched smoking cessation treatment (RR 1.44, 95% CI 0.40 to 5.16; 1 study, 55 participants; very low-certainty evidence). Excluding studies at high risk of bias did not substantially alter the results, nor did using complete case data as opposed to using data from all participants randomised. Nine studies reported on changes in mental health and well-being, including depression, anxiety, perceived stress, and negative and positive affect. Variation in measures and methodological differences between studies meant we could not meta-analyse these data. One study found a greater reduction in perceived stress in participants who received a face-to-face mindfulness training programme versus an intensity-matched programme. However, the remaining eight studies found no clinically meaningful differences in mental health and well-being between participants who received mindfulness-based treatments and participants who received another treatment or no treatment (very low-certainty evidence).
Authors' conclusions:
We did not detect a clear benefit of mindfulness-based smoking cessation interventions for increasing smoking quit rates or changing mental health and well-being. This was the case when compared with intensity-matched smoking cessation treatment, less intensive smoking cessation treatment, or no treatment. However, the evidence was of low and very low certainty due to risk of bias, inconsistency, and imprecision, meaning future evidence may very likely change our interpretation of the results. Further RCTs of mindfulness-based interventions for smoking cessation compared with active comparators are needed. There is also a need for more consistent reporting of mental health and well-being outcomes in studies of mindfulness-based interventions for smoking cessation.
Background:
Alcohol abuse is a public health problem and the course of alcohol dependence syndrome (ADS) is known for its relapsing nature. Additional interventions with empirical evidence are worthy of consideration. Breathing and Relaxation Training, like Sudarshan Kriya (SK) is recommended for stress management, and have been shown to positively affect outcomes in stress-related disorders. The aim of this study was to assess the effect of an intervention of Breathing and Relaxation Training, on drinking behavior in patients of ADS.
Methodology:
Eighty in-patients diagnosed with ADS were included after obtaining informed consent, in this prospective study and were randomized into two groups. They were administered Alcohol Use Disorder Identification Test (AUDIT) at admission and 6-months after discharge. The Study group (n = 40) underwent a 6-day intervention of Breathing and relaxation Training (SK) apart from the standard therapy. "WHO-5 Well-Being Index" was administered before and after the training. The Control group was exposed to the standard therapy for ADS. A follow-up on a monthly basis and finally at 6-month interval was done to assess alcohol consumption status.
Results:
Socio-demographically both the groups were comparable. The breathing and relaxation training (study) group had a significant rise in "WHO-5 Well-Being Index" (P < 0.001). There was a significant reduction in AUDIT scores after 6 months in both groups. AUDIT scores were significantly lower in the study group (11.20 ± 2.81) than the control group (15.30 ± 4.05) after 6 months (P < 0.001). The study group also reported fewer days of drinking (P = 0.004) and reduced overall drinking in the intervening period (P < 0.001).
Conclusion:
The addition of Breathing and Relaxation Training (SK) in the management of ADS provided additional therapeutic benefits in the form of fewer days of drinking and reduced total alcohol consumption.
Introduction:
Interventions based on Yogic Breathing Practices (IB-YBP) have shown promising results for substance use disorders (SUD). Research in this area is methodologically heterogeneous and only a few, but restricted, systematic reviews are available. The current systematic review aims to assess the effectiveness of IB-YBP for SUD. Materials and Methods: PubMed, Cochrane's Library, EBSCO-Medline, and Google Scholar databases were searched for the randomized- (RCTs) and quasi-randomized trials. Research involving participants with SUD, of either gender or any age, assessing the effectiveness of the IB-YBP either as a standalone intervention or as an adjuvant to standard treatment versus standard pharmacological/non-pharmacological treatment or no-intervention control were included. Studies having participants with co-morbid psychiatric illness and interventions not having IB-YBP as the predominant component were excluded. Results: The initial literature search yielded 396 articles and upon screening, only 14 studies were found eligible for this review. Most studies have researched IB-YBP as an adjunct to the standard treatment for SUD. Evidence for the effectiveness of IB-YBP is mostly available for tobacco and opioid use disorders, though only for short-term outcomes; however, literature is scarce for alcohol- and cocaine-use disorders. This review documented the effectiveness of the IB-YBP for substance use-related outcome parameters such as abstinence, quality of life (QoL), mood, craving, and withdrawal symptoms. Conclusion: IB-YBP may be an effective adjuvant to standard treatment for various SUD. However, more research is required to compare its effectiveness with standard treatment, and assessing its long-term efficacy, for it to be strongly recommended as a treatment strategy.
Important counter measures to combat an infectious disease pandemic include vaccination, antiviral therapy, and immunomodulation therapy. Vaccinations are disease specific and moreover strain specific, so the protection provided is also specific and limited. Antiviral therapies are costly and require bulk production of drugs, hence globally there is an increased interest toward low-risk, cost-effective complementary alternative therapies, such as Yoga and Ayurveda to tackle the infectious pandemic, coronavirus disease 2019 (COVID-19). There is clinical evidence available on the potential complementary role of yogic practices in the management of noncommunicable and communicable diseases. Various online databases were searched for articles published between 2000 and 2020. Databases explored were Medline, EMBASE, Indian Citation Index, PsycINFO, Index Medicus for South-East Asia Region, and Google Scholar. All search results were screened, and articles related to keywords such as COVID-19, yoga therapy, and Sudarshan Kriya Yoga (SKY) were selected for data extraction. Quality of the studies included was evaluated on the basis of the construct validity, content validity, relevance, bias, credibility relating to information, and data sources. SKY is a unique yogic practice that includes specific sequential breathing techniques. It balances the autonomic nervous system and thus can alleviate anxiety, routine stress, depression, stress-related medical disorders, and posttraumatic stress. It potentiates natural host immune defenses that are essential to tackle a plethora of microbial infections. This narrative review article provides an overview of potential therapeutic benefits that SKY can offer to the population at large during this COVID-19 pandemic.
Background
The COVID-19 pandemic has created unprecedented challenges for healthcare globally, the brunt of which has been borne by the health care providers (HCPs). These challenges are felt more keenly in India, as they stretch an insufficiently resourced healthcare system. The long hours, cross over of responsibilities, lack of resources to adequately care for patients, and concerns around safety of self and loves ones, have led to a spike in anxiety, depression, insomnia and other stress – related disorders in healthcare providers. Sudarshan Kriya Yoga (SKY) is a mind-body intervention that has been studied in multiple clinical populations. Prior to this study, there has been no exploration of the impact of SKY on healthcare providers, specifically the impact of a mind-body intervention like SKY on HCPs during a pandemic.
Objective
This study aims to investigate the impact of SKY on the well-being of HCPs during the COVID-19 pandemic.
Methods
We conducted a pilot feasibility study with a single arm pre-post design. SKY was taught to participants in a 4-day online breath and meditation workshop. We measured outcomes related to depression, anxiety, resilience, life satisfaction, and quality of sleep.
Results
Ninety-two subjects completed the study survey before and after the intervention. A significant reduction was observed in the levels of stress, anxiety and depression immediately after the program. In addition, the participants reported sig1nificant improvement in life satisfaction, resilience, and the quality of their sleep.
Conclusion
The results indicate that SKY breathing technique had a positive impact on the well-being of healthcare professionals during the pandemic. Participants experienced improved quality of sleep, enhanced satisfaction with life, and increased resilience after SKY. This pilot study provides important data for future multi-site randomized controlled trials to study the impact of yogic techniques on well-being of the HCPs.
Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. The main reason for increase of CVD is considered to be unhealthy lifestyle consistent of high fat, refined diet, psychosocial stress, lack of exercise and tobacco. In spite of several recent advances in the management of CVD the incidence is rapidly increasing specially in the developing countries and their economic burden is huge. There is a need for new cost effective and safe strategy to control this growing epidemic of CVD. Yoga may be such an alternative for controlling CVD. Several research studies suggest that yoga may be promising technique for primary and secondary prevention of CVD and these will be reviewed briefly in this chapter.
Several common problems of women seem to be on the increase due to the changing life style of urbanization and material progress. Alarming increase in the prevalence of many non- communicable diseases of women such as PMS, mastalgia, PCOS, complications of pregnancy, menopausal syndrome and breast cancer have become a major challenge in all countries round the globe. This chapter covers the principles and practice of yoga in some of these common conditions specific to women. The chapter covers the conceptual basis of yoga in these conditions with a proposed yoga model of the disease and the recommended yoga module for each of these conditions. This chapter covers the principles and practices of yoga in some of the common life style related health problems of women such as premenstrual syndrome (PMS), pregnancy, polycystic ovarian syndrome (PCOS), peri-menopausal difficulties and breast cancer, under the following headings: the rationale for using yoga, practically applicable yoga modules and a summary of the published research work.
Yoga, as both a science and art, elicits neurochemical response mediated by neurophysiological mechanisms, and when used in rehabilitation, can honor both its cultural philosophy while evolving as an evidence-based therapy. The central theme of this chapter is to provide a foundation for a novel yogic model of rehabilitation practice using proposed common psychotherapeutic and physiological factors that affect patient outcomes. This model is guided by Ten Precepts that can guide the use of yoga in rehabilitation as a medical, therapeutic, yoga, in order to foster evidence-based practice, which is representative of best practice techniques in rehabilitation. The 10 Precepts include guidelines on optimization of patient assessment and intervention, education, respiratory function as a first-line psychophysiological intervention, fostering stability and safety through six evidence-based neurophysiological principles, inclusion of Ayurveda and other yogic tools, and non-dogmatic yoga practice in rehabilitation.
Cardiovascular diseases (CVD) are the leading cause of death and disability worldwide. The main reason for increase of CVD is considered to be unhealthy lifestyle consistent of high fat, refined diet, psychosocial stress, lack of exercise and tobacco. In spite of several recent advances in the management of CVD the incidence is rapidly increasing specially in the developing countries and their economic burden is huge. There is a need for new cost effective and safe strategy to control this growing epidemic of CVD. Yoga may be such an alternative for controlling CVD. Several research studies suggest that yoga may be promising technique for primary and secondary prevention of CVD and these will be reviewed briefly in this chapter.
Currently, the entire globe is facing a pandemic 'COVID-19' and the numbers are rising exponentially. Unfortunately, along with the triple burden of malnutrition and many non-communicable diseases, Corona virus has knocked India's door. As we don't know for how long this battle will continue, the present review is an attempt to highlight the importance of non-pharmacological approaches like a balanced diet, stress management, adequate sleep and physical activity to build up a strong immune system, as it reduces the complications in individuals who are already at nutritional risk and might get exposed to the infection. Globally, scientists are working to find potential vaccines to combat COVID-19, meanwhile, we must utilize this time window in building our immunity by adopting a healthy dietary and other lifestyle measures. Hence, it is the need of the hour to build up immunity by adopting a holistic approach as there is no nutritional magic pill, which can boost immunity instantly.
The purpose of this review is to present yoga as an important tool for both disease prevention and health care. Yoga involves a holistic approach that lacks the mechanistic fragmentation of the impact on individual organs and body systems, which arises from much of the specialization found in modern medicine. Lifestyle diseases are increasingly a problem. The incidence of diabetes, hypertension, atherosclerosis, cancer, mental illness and obesity is increasing worldwide. This is true even of countries that, until recently, followed a traditional way of life. Technology, the pace of life, stress, and reduced physical activity serve to degrade the general level of health in societies across the globe. In Western societies, these factors have raised the demand for preventive and therapeutic antidotes, leading Westerners to turn to traditional yoga, which is, however, often modified to the point of distorting its essence. In its original nature yoga is a non-religious, psychosomatic system based on natural laws, inspired by science to act on the body in a way that is integrated into the natural world. The system of Ayurvedic medicine works in parallel with yoga, aiming at the same holistic effect. Both it and the various elements of yoga, in particular asanas (postures), are the means of effecting beneficial changes in psychosomatic functioning. Yoga itself relaxes and strengthens physical movement, focusing particular attention on the mobility of the spine. It is also the perfect medium for achieving mental balance. These properties of yoga have made it useful in the treatment of cancer and other modern diseases, in slowing the body’s aging process, and in achieving general welfare and well-being. More intense forms of yoga practice, such as the ancient method of fitness training called Suryanamaskar, have demonstrated their effectiveness in preventing and treating cardiovascular diseases, respiratory ailments and other conditions.
Context:
Respiration is known to modulate neuronal oscillations in the brain and is measured by electroencephalogram (EEG). Sudarshan Kriya Yoga (SKY) is a popular breathing process and is established for its significant effects on the various aspects of physiology and psychology.
Aims:
This study aimed to observe neuronal oscillations in multifrequency bands and interhemispheric synchronization following SKY.
Settings and design:
This study employed before- and after-study design.
Subjects and methods:
Forty healthy volunteers (average age 25.45 ± 5.75, 23 males and 17 females) participated in the study. Nineteen-channel EEG was recorded and analyzed for 5 min each: before and after SKY. Spectral power for delta, theta, alpha, beta, and gamma frequency band was calculated using Multi-taper Fast Fourier Transform (Chronux toolbox). The Asymmetry Index was calculated by subtracting the natural log of powers of left (L) hemisphere from the right® to show interhemispheric synchronization.
Statistical analysis:
Paired t-test was used for statistical analysis.
Results:
Spectral power increased significantly in all frequency bands bilaterally in frontal, central, parietal, temporal, and occipital regions of the brain after long SKY. Electrical activity shifted from lower to higher frequency range with a significant rise in the gamma and beta powers following SKY. Asymmetry Index values tended toward 0 following SKY.
Conclusions:
A single session of SKY generates global brain rhythm dominantly with high-frequency cerebral activation and initiates appropriate interhemispheric synchronization in brain rhythms as state effects. This suggests that SKY leads to better attention, memory, and emotional and autonomic control along with enhanced cognitive functions, which finally improves physical and mental well-being.
Background:
Pranayama (yogic breathing) has demonstrated numerous beneficial health effects. At present, there are no systematic reviews evaluating the beneficial health effects of pranayama alone as a practice.
Aim:
The aim of this study is to perform a systematic review about the beneficial health effects of pranayama.
Methods:
Data were obtained using a stepwise search process by searching the online PubMed, Web of Science, and SciVerse Scopus databases using keywords. Controlled clinical trials in humans, using "Pranayama" as an intervention with an appropriate control group and evaluating health-related outcomes were selected for inclusion.
Results:
Initial database searching indicated 669 potentially eligible articles, of which 18 studies satisfying the inclusion/exclusion criteria were selected. All were controlled trials, of which 13 were randomized and 1 was a crossover study. Number of participants ranged from 16 to 160, and the duration of pranayama practice varied from 4 days to 6 months. Studies demonstrated a significant effect on cardiorespiratory functions, in patients with bronchial asthma, with the improvement of pulse rate, systolic blood pressure, and respiratory function measurements. Furthermore, reduction in the frequency of attacks, severity, and medication requirement was also observed, with improved quality of life (QOL). In patients with chronic obstructive pulmonary disease, symptom, activity, and impact scores were improved. QOL improvement was also noted in cancer patients.
Conclusions:
Available evidence on pranayama indicates physiological and psychological benefits. Beneficial effects were mostly observed in patients with respiratory diseases such as bronchial asthma. It also helped those with cancer and cardiovascular disease. However, further high-quality randomized trials are required to provide definitive evidence.
Male reproductive fitness has faced significant challenges in the current scenario. Derangement in the fertility spectrum has been associated with a host of modifiable and non-modifiable lifestyle factors and affected by equally contributing holistic, complementary and alternative therapies for their management. Infertility has stepped up the ladder to be considered among the complex chronic lifestyle conditions. Infertile men not only face challenges in reproductive potential but deranged seminal parameters are also a gateway to the overall health since infertility in men may pose as a harbinger of various medical conditions later in life. This chapter intends to portray an outline of various complementary therapies being adopted as an adjunct to modern medicine for the management of male infertility because male reproductive health and general health are largely intertwined.
The world Health Organization defines health as complete well-being in terms of physical, mental and social, and not merely the absence of disease. To attain this, individual should adapt and self-mange the social, physical and emotional challenges of life. Exposure to chronic stress due to urbanization, work stress, nuclear family, pollution, unhealthy food habits, lifestyle, accidental death in the family, and natural calamities are the triggering factors, leading to hormonal imbalance and inflammation in the tissue. The relationship between stress and illness is complex; all chronic illnesses such as cardiovascular disease and asthma have their root in chronic stress attributed by inflammation. In recent
times, yoga therapy has emerged as an important complementary alternative medicine for many human diseases. Yoga therapy has a positive impact on mind and body; it acts by incorporating appropriate breathing techniques and mindfulness to attain conscious direction of our awareness of the present moment by meditation, which helps achieve harmony between the body and mind. Studies have also demonstrated the important regulatory effects of yoga therapy on brain structure and functions. Despite these advances, the cellular and molecular mechanisms by which yoga therapy renders its
beneficial effects are inadequately known. A growing body of evidence suggests that yoga therapy has immunomodulatory effects. However, the precise mechanistic basis has not been addressed empirically. In this review, we have attempted to highlight the effect of yoga therapy on immune system functioning with an aim to identify important immunological signatures that index the effect of yoga therapy.Toward this, we have summarized the available scientific evidence showing positive impacts of yogatherapy. Finally, we have emphasized the efficacy of yoga in improving physical and mental well‑being.Yoga has been a part of Indian culture and tradition for long; now, the time has come to scientificallyvalidate this and implement this as an alternative treatment method for stress‑related chronic disease.
Yoga, as both a science and art, elicits neurochemical response mediated by neurophysiological mechanisms, and when used in rehabilitation, can honor both its cultural philosophy while evolving as an evidencebased therapy. The central theme of this chapter is to provide a foundation for a novel yogic model of rehabilitation practice using proposed common psychotherapeutic and physiological factors that affect patient outcomes. This model is guided by Ten Precepts that can guide the use of yoga in rehabilitation as a medical, therapeutic, yoga, in order to foster evidence-based practice, which is representative of best practice techniques in rehabilitation. The 10 Precepts include guidelines on optimization of patient assessment and intervention, education, respiratory function as a first-line psychophysiological intervention, fostering stability and safety through six evidence-based neurophysiological principles, inclusion of Ayurveda and other yogic tools, and non-dogmatic yoga practice in rehabilitation.
There is ample evidence from human and animal studies demonstrating the downward modulation of immune function concomitant with a variety of stressors. As a consequence, the possible enhancement of immune function by behavioral strategies has generated considerable interest. Researchers have used a number of diverse strategies to modulate immune function, including relaxation, hypnosis, exercise, classical conditioning, self-disclosure, exposure to a phobic stressor to enhance perceived coping self-efficacy, and cognitive-behavioral interventions, and these interventions have generally produced positive changes. Although it is not yet clear to what extent these positive immunological changes translate into any concrete improvements in relevant aspects of health, that is, alterations in the incidence, severity, or duration of infectious or malignant disease, the preliminary evidence is promising.
The present study measured the effects of relaxation and guided imagery on cellular immune function. During a period of 10 days 10 healthy subjects were given one 1-hour relaxation procedure and one combined relaxation and guided imagery procedure, instructing the subjects to imagine their immune system becoming very effective. Even though no major changes in the composition of the major mononuclear leukocyte subsets could be demonstrated a significant increase in natural killer function was demonstrated. These data suggest that relaxation and guided imagery might have a beneficial effect on the immune defense and could form the basis of further studies on psychological intervention and immunological status.
This study investigated whether social support was related to immune function among spouses of cancer patients. Effects of depression and negative life events were examined as potential mediators. Results showed evidence of greater immunocompetence on 2 of 3 dynamic measures: natural killer cytotoxicity and proliferation response to phytohemagglutinin among spouses who reported high levels of social support. All six components of social support assessed by the Social Provisions Scale (Cutrona & Russell, 1987) were strongly related to these indices of immune function. No evidence was found for mediation by either life events or depression.
This study assessed the enhancement of immunocompetence by relaxation and social contact in 45 geriatric residents of independent-living facilities. Subjects were randomly assigned to one of three protocols: relaxation training, social contact, or no contact. Subjects in the relaxation and social-contact conditions were seen individually three times a week for a month. Blood samples and self-report data were obtained at baseline, at the end of the intervention, and at a 1-month follow-up. At the end of the intervention, the relaxation group showed a significant increase in natural killer cell activity, and significant decreases in antibody titers to Herpes simplex virus and self-rated distress; the other two groups showed nonsignificant changes. There was a general increase in the T-lymphocyte response to phytohemagglutinin stimulation at the end of the intervention, with greater change at lower mitogen concentrations. These data suggest that cellular immunocompetence may be enhanced by psychosocial interventions.
Supportive-expressive group therapy has been reported to prolong survival among women with metastatic breast cancer. However, in recent studies, various psychosocial interventions have not prolonged survival.
In a multicenter trial, we randomly assigned 235 women with metastatic breast cancer who were expected to survive at least three months in a 2:1 ratio to an intervention group that participated in weekly supportive-expressive group therapy (158 women) or to a control group that received no such intervention (77 women). All the women received educational materials and any medical or psychosocial care that was deemed necessary. The primary outcome was survival; psychosocial function was assessed by self-reported questionnaires.
Women assigned to supportive-expressive therapy had greater improvement in psychological symptoms and reported less pain (P=0.04) than women in the control group. A significant interaction of treatment-group assignment with base-line psychological score was found (P</=0.003 for the comparison of mood variables; P=0.04 for the comparison of pain); women who were more distressed benefited, whereas those who were less distressed did not. The psychological intervention did not prolong survival (median survival, 17.9 months in the intervention group and 17.6 months in the control group; hazard ratio for death according to the univariate analysis, 1.06 [95 percent confidence interval, 0.78 to 1.45]; hazard ratio according to the multivariate analysis, 1.23 [95 percent confidence interval, 0.88 to 1.72]).
Supportive-expressive group therapy does not prolong survival in women with metastatic breast cancer. It improves mood and the perception of pain, particularly in women who are initially more distressed.
In summary, there is substantial evidence from both healthy populations as well as individuals with cancer linking psychological stress with immune dysregulation. Stress may also enhance carcinogenesis through alterations in DNA repair and/or apoptosis [31-33]. In addition, the possibility that psychological interventions may enhance immune function and survival among cancer patients is still an open question [43, 44], as is the evidence suggesting that social support may be a key psychological mediator. However, these studies and others suggest that psychological or behavioral factors could influence the initiation/progression of cancer. Further studies to explain these relationships need to be performed.
Research has found suggestive links between emotional distress and immune and neuroendocrine measures in cancer patients. Furthermore, several studies have reported that participation in psychological support groups is associated with better health outcomes for cancer patients. However, controversy exists surrounding these findings, and the mechanisms behind such effects are unclear. This article integrates current evidence from several lines of research concerning the relations among coping, psychological adjustment, cortisol and immune function, and disease progression in breast cancer patients. A biopsychosocial model is evaluated in which coping and psychological adjustment are associated with alterations in cortisol levels, immune function, and potential long-term medical outcomes in breast cancer patients. Although strong evidence suggests that coping and psychosocial intervention can improve psychological outcomes for breast cancer patients, potential effects on physiological outcomes remain speculative.
The effect of psychosocial intervention on time of survival of 86 patients with metastatic breast cancer was studied prospectively. The 1 year intervention consisted of weekly supportive group therapy with self-hypnosis for pain. Both the treatment (n = 50) and control groups (n = 36) had routine oncological care. At 10 year follow-up, only 3 of the patients were alive, and death records were obtained for the other 83. Survival from time of randomisation and onset of intervention was a mean 36.6 (SD 37.6) months in the intervention group compared with 18.9 (10.8) months in the control group, a significant difference. Survival plots indicated that divergence in survival began at 20 months after entry, or 8 months after intervention ended.
Immunologists long viewed the immune system as self-contained, functioning autonomously in defense of the body. That view is no longer tenable. Evidence that the brain and immune system interact with each other is now overwhelming, as is amply documented in other chapters of this book. In this chapter, we explore potential implications of psychoneuroimmunology for oncology, focusing first on the “conventional view” that psychological influences on immune defenses may be the mechanism by which psychological influences on immune defenses may be the mechanism by which psychosocial factors may affect the development and/or progression of cancer (Bovbjerg, 1994). We then explore other ways in which psychoneuroimmunology may be relevant for oncology, including associations with infectious disease, and possible dysfunction in regulatory loops between the brain and immune system.
Objectives:
We evaluated recurrence and survival for 68 patients with malignant melanoma who participated in a 6-week structured psychiatric group intervention 5 to 6 years earlier, shortly after their diagnosis and initial surgical treatment. We also explored the role of several factors as possible predictors of outcome.
Design:
This was a randomized controlled experimental study. The Cox proportion hazards regression model was used to quantify the relationship between treatment and the outcomes adjusted by the covariates (age, sex, Breslow depth, tumor site, baseline Profile of Mood States Total Mood Disturbance, baseline active-behavioral coping, baseline natural killer cell activity, and treatment [ie, group intervention]). The stepwise procedure was used for covariate selection.
Results:
For control patients, there was a trend for recurrence (13/34) and a statistically significant greater rate of death (10/34) than for experimental patients (7/34 and 3/34, respectively). We found that being male and having a greater Breslow depth predicted greater recurrence and poorer survival. Analysis of multiple covariates found that only Breslow depth and treatment (ie, group intervention) were significant. Adjusting for Breslow depth, treatment effect remained significant. Finally, baseline affective distress and baseline coping were significant psychobehavioral predictors for recurrence and survival. Surprisingly, higher levels of baseline distress as well as baseline coping and enhancement of active-behavioral coping over time were predictive of lower rates of recurrence and death.
Conclusion:
Psychiatric interventions that enhance effective coping and reduce affective distress appear to have beneficial effects on survival but are not proposed as an alternative or independent treatment for cancer or any other illness or disease. However, the exact nature of this relationship warrants further investigation.
This article reviews evidence that psychosocial support may influence the progression of cancer, as indicated by differences in length of survival. Psychotherapeutic methods that have proved to be effective involve direct confrontation of fears; expression of affect, including aegative feelings; provision of social support; and training in self-hypnosis for analgesia. Possible mechanisms for this psychosocial effect on progression of disease include changes in diet and exercise, better use and provision of health care, and positive effects on the sensitivity of the endocrine and immune systems to stress. The author reviews the limitations of these theories and offers suggestions for future research.
This report summarizes data from social confrontations studies in laboratory rats dealing with the effects of psychosocial stress on immune functioning and tumor metastasis. The paper focuses on the physiological alterations observed in subdominant males after 2 days of continuous social confrontation. A significant loss of body mass and elevated plasma concentrations of adrenal hormones in subdominant males indicate a stressful social environment. Subdominant males showed lower numbers of blood CD4 and CD8 T cells as well as reduced activity levels of T cells and natural killer (NK) cells relative to control subjects. In order to evaluate the possible health impact of suppressed NK functioning, we used the MADB 106 tumor model. A 10-fold lower tumor clearance in subdominant males demonstrates suppression of the animals' capacity to prevent metastatic development. The relationship between individual behavior and immunological outcome is briefly discussed. Together, the study of male rats in social confrontations appears to be a good model to investigate stress-induced immune modulation and tumor metastasis under relatively naturalistic social conditions.
Les liens entre le tabagisme et divers déterminants sociodémographiques ou socioéconomiques, de même que les interactions entre humeur dépressive et tabagisme sont déjà connus. Toutefois, le poids respectif des facteurs d’ordre psychologique et de certains antécédents biographiques traumatiques au cours de l’enfance et de l’adolescence mérite d’être précisé.
This study investigated the effect of daily relaxation on concentrations of serum immunoglobulins A, G, and M and secretion rates of salivary immunoglobulin A (S-IgA). Twenty-four volunteers were randomly assigned to practice a relaxation technique daily for 3 weeks and 16 to a waiting list control condition. Blood and saliva samples were collected before and after a supervised 20-min relaxation session at the beginning and end of the 3-week practice period. S-IgA secretion rate increased significantly (pbefore to after relaxation samples was higher (p=.014) in subjects who had practiced relaxation once a day for 3 weeks than in waiting list control subjects practicing for the first time. Serum IgA (ppp
It is becoming well accepted that products of the immune system (cytokines) can signal the brain that infection has occurred. This cytokine-to-brain communication can result in marked alterations in brain function and behavior. This review examines alternative mechanisms that have been proposed to explain how such immune products can reach the brain via the blood to cause centrally-mediated “illness” responses. Finally, we describe a new view which argues that cytokines signal brain in quite a different manner, by stimulating afferent terminals of peripheral nerves at local sites of synthesis and release.
The mechanisms of stress-related immune alterations have not been fully elucidated. Cell-mediated immune responses as well as antibody and certain cytokines are reported as being suppressed during times of high stress. However, the role of suppression vs dysregulation has not been established in human stress models. The effect of exam stress on regulatory cytokines in 16 healthy medical students was assessed by measuring type-1 (IFN-γ) and type-2 (IL-10) cytokines from 72-h PHA/PMA-stimulated PBMC 4 weeks before and 48 h after exams. Results demonstrated decreased IFN-γ accompanied by increased IL-10 during exam stress that resulted in a decreased IFN-γ:IL-10 ratio. There was a significant correlation between the cytokine response to PHA/PMA and number and subjective adjustment to daily hassles. Additionally, students who reported greater levels of loneliness also reported greater numbers of and poorer subjective adjustment to hassles. The differences were consistent in both males and females but did not correlate with AM cortisol levels. Additionally, when individuals were grouped into high vs low preexam hassle levels, the type-1/type-2 shift in the IFN-γ:IL-10 ratio occurred in the low hassles group only. These data suggest that psychologically stressful situations shift type-1/type-2 cytokine balance toward type-2 and result in an immune dysregulation rather than overall immunosuppression. This may partially explain the increased incidence of type-2-mediated conditions such as increased viral infections, latent viral expression, allergic/asthmatic reactions, and autoimmunity reported during periods of high stress.
We now have substantial evidence demonstrating noradrenergic sympathetic and peptidergic innervation of both primary and secondary lymphoid organs. We have established criteria for norepinephrine, and some of the neuropeptides, as neurotransmitters, and have found changes in immune responsiveness following pharmacological manipulation of noradrenergic sympathetic or peptidergic nerves. Classic receptor binding studies have demonstrated a wide variety of target cells that possess beta-adrenoceptors and receptors for neuropeptides on cells of the immune system, including lymphocyte subsets, macrophages, accessory cells, or stromal elements. In this chapter we describe noradrenergic and peptidergic innervation of primary and secondary lymphoid organs in development, at maturation and during the normal aging process, and discuss possible functional implications of direct neural signals onto cells of the immune system at critical time points in the lifespan of an animal. Further, we examine for involvement of noradrenergic sympathetic and peptidergic innervation in the development and progression of several autoimmune disorders, including adjuvant-induced arthritis, New Zealand mice strains as a model for hemolytic anemia and lupus-like syndrome, and the experimental allergic encephalomyelitis model for multiple sclerosis.
The effect of biofeedback-assisted relaxation on cell-mediated immunity, cortisol, and white blood cell count was investigated in healthy adults under low-stress conditions. Fourteen subjects were trained with biofeedback-assisted relaxation for 4 weeks, while 17 subjects were controls. The group trained in relaxation techniques showed increased blastogenesis, decreased white blood cell count, due to decreased neutrophils, and no change in cortisol in comparison to the control group. Subjects with lower initial anxiety scores and forehead muscle tension levels showed larger increases in blastogenesis and larger decreases in neutrophils than subjects with higher initial anxiety and muscle tension levels.
Accumulating evidence indicates that the central nervous system (CNS) may regulate the activity of the immune system. Although the overall significance of the immune system in cancer remains controversial, psychosocial influences on immune function could potentially provide a mechanism to account for some of the reports of an association between psychosocial factors and cancer prognosis.
We evaluated the immediate and long-term effects on immune function measures of a 6-week structure psychiatric group intervention for patients with malignant melanoma. Along with a reduction in levels of psychological distress and greater use of active coping methods, the following immune changes were seen at the 6-month assessment point in the intervention-group patients (n = 35) compared with controls (n = 26): significant increases in the percent of large granular lymphocytes (defined as CD57 with Leu-7) and natural killer (NK) cells (defined as CD16 with Leu-11 and CD56 with NKH1) along with indications of increase in NK cytotoxic activity; and a small decrease in the percent of CD4 (helper/inducer) T cells. At the 6-week follow-up point, the majority of these changes were not yet observable. The results indicate that a short-term psychiatric group intervention in patients with malignant melanoma with a good prognosis was associated with longer-term changes in affective state, coping, and the NK lymphoid cell system. Affective rather than coping measures showed some significant correlations with immune cell changes.
The effect of psychosocial intervention on time of survival of 86 patients with metastatic breast cancer was studied prospectively. The 1 year intervention consisted of weekly supportive group therapy with self-hypnosis for pain. Both the treatment (n = 50) and control groups (n = 36) had routine oncological care. At 10 year follow-up, only 3 of the patients were alive, and death records were obtained for the other 83. Survival from time of randomisation and onset of intervention was a mean 36.6 (SD 37.6) months in the intervention group compared with 18.9 (10.8) months in the control group, a significant difference. Survival plots indicated that divergence in survival began at 20 months after entry, or 8 months after intervention ended.
Hepatocyte-stimulating factor and interleukin-1 are proteins produced by monocytes in response to inflammatory challenge.
Neither of these monokines had direct effects on steroid production by cultured adrenocortical cells. Both monokines stimulated
pituitary cells (AtT-20) to release adrenocorticotropic hormone; interleukin-1 was equipotent with a combination of corticotropin-releasing
factor and arginine vasopressin, and hepatocyte-stimulating factor was at least three times as effective. The synthetic glucocorticoid,
dexamethasone, inhibited production of hepatocyte-stimulating factor by cultured monocytes. These results indicate an axis
between monocytes and pituitary and adrenocortical cells which may play a role in regulating host defense.
This study investigated the effect of daily relaxation on concentrations of serum immunoglobulins A, G, and M and secretion rates of salivary immunoglobulin A (S-IgA). Twenty-four volunteers were randomly assigned to practice a relaxation technique daily for 3 weeks and 16 to a waiting list control condition. Blood and saliva samples were collected before and after a supervised 20-min relaxation session at the beginning and end of the 3-week practice period. S-IgA secretion rate increased significantly (p less than .001) after 20 min of relaxation. A longer-term practice effect also occurred in that the increase in secretion rate in "before to after" relaxation samples was higher (p = .014) in subjects who had practiced relaxation once a day for 3 weeks than in waiting list control subjects practicing for the first time. Serum IgA (p less than .001), IgG (p less than .001), and igM (p less than .05) increased significantly over the 3-week practice period. Relaxation may be a self-regulating strategy affecting both humoral and cellular divisions of the immune system.
Natural killer cell (NK) activity, which is important in the defense against tumors and viral infections, is reduced in women undergoing conjugal bereavement. The relationship between NK activity and plasma cortisol was investigated in three groups of subjects: women who were anticipating the death of their husbands, women whose husbands had recently died, and controls. Bereaved women showed reduced NK activity and increased plasma cortisol levels as compared to controls. Anticipatory bereaved women also showed significant reductions in NK activity, but had levels of plasma cortisol comparable to those of controls. The reduction of NK activity during anticipatory and actual bereavement cannot be explained solely on the basis of increased cortisol secretion.
Anti-alpha-corticotropin [anti-ACTH alpha (1-13)](also alpha-melanotropin) and anti-gamma-endorphin antisera neutralized human leukocyte interferon activity but not fibroblast interferon activity. Human leukocyte interferon was not neutralized by anti-human lutenizing hormone (lutropin) or follicle-stimulating hormone (follitropin) antisra. Conversely, antisera to human leukocyte interferon neutralized ACTH activity. The neturalization of human leukocyte interferon by anti-human leukocyte interferon serum was partially blocked by ACTH. These studies show strong antigenic relatedness among human leukocyte interferon, ACTH, and endorphins, implying that there are underlying structural similarities. Structural relatedness is shown by pepsin cleavage of ACTH activity from human leukocyte interferon. The implication for the natural functions of human leukocyte interferon are discussed.
Natural killer cells are a recently discovered subpopulation of lymphoid cells that are present in most normal individuals
of a range of mammalian and avian species. Natural killer cells have spontaneous cytolytic activity against a variety of tumor
cells and some normal cells, and their reactivity can be rapidly augmented by interferon. They have characteristics distinct
from other types of lymphoid cells and are closely associated with large granular lymphocytes, which comprise about 5 percent
of blood or splenic leukocytes. There is increasing evidence that natural killer cells, with the ability to mediate natural
resistance against tumors in vivo, certain virus and other microbial diseases, and bone marrow transplants, may play an important
role in immune surveillance.
Although increased morbidity and mortality have been reliably associated with social isolation and less satisfying personal relationships, relatively little is known about the underlying biopsychosocial mechanisms. We assessed problem-solving behaviors and changes in immune function in 90 newlywed couples who were admitted to a hospital research unit for 24 hours. Subjects who exhibited more negative or hostile behaviors during a 30-minute discussion of marital problems showed greater decrements over 24 hours relative to low negative subjects on four functional immunological assays (natural killer cell lysis, blastogenic response to two mitogens, and the proliferative response to a monoclonal antibody to the T3 receptor), as well as larger increases in the numbers of total T lymphocytes and helper T lymphocytes. High negative subjects had higher antibody titers to latent Epstein-Barr virus than low negative subjects, consistent with down-regulated immune function. Women were more likely to show negative immunological changes than men. The discussion of marital problems also led to larger increases in blood pressure that remained elevated longer in high negative subjects than low negative subjects. Positive or supportive problem-solving behaviors were not related to either immunological or blood pressure changes. These physiological differences were particularly noteworthy because marital satisfaction was high in both groups, and couples had been selected on the basis of stringent mental and physical health criteria. These data provide additional support for the link between personal relationships and immune function.
We evaluated recurrence and survival for 68 patients with malignant melanoma who participated in a 6-week structured psychiatric group intervention 5 to 6 years earlier, shortly after their diagnosis and initial surgical treatment. We also explored the role of several factors as possible predictors of outcome.
This was a randomized controlled experimental study. The Cox proportion hazards regression model was used to quantify the relationship between treatment and the outcomes adjusted by the covariates (age, sex, Breslow depth, tumor site, baseline Profile of Mood States Total Mood Disturbance, baseline active-behavioral coping, baseline natural killer cell activity, and treatment [ie, group intervention]). The stepwise procedure was used for covariate selection.
For control patients, there was a trend for recurrence (13/34) and a statistically significant greater rate of death (10/34) than for experimental patients (7/34 and 3/34, respectively). We found that being male and having a greater Breslow depth predicted greater recurrence and poorer survival. Analysis of multiple covariates found that only Breslow depth and treatment (ie, group intervention) were significant. Adjusting for Breslow depth, treatment effect remained significant. Finally, baseline affective distress and baseline coping were significant psychobehavioral predictors for recurrence and survival. Surprisingly, higher levels of baseline distress as well as baseline coping and enhancement of active-behavioral coping over time were predictive of lower rates of recurrence and death.
Psychiatric interventions that enhance effective coping and reduce affective distress appear to have beneficial effects on survival but are not proposed as an alternative or independent treatment for cancer or any other illness or disease. However, the exact nature of this relationship warrants further investigation.
We investigated the effect of social isolation stress on the formation of experimental liver metastasis resulted from intraportal vein (i.p.v.) injection of colon 26-L5 carcinoma cells in male Balb/c mice, and elucidated some of the underlying mechanism involving the effects of this stress on cellular immunity. Increases in the colony number and tumor burden were observed in the mice socially isolated before and/or after tumor cell challenge, as compared with the group-housed mice. In addition, exposure of mice to 2 weeks of preisolation resulted in decreases in the thymus weight and number of thymocytes by 35.8% and 40.2%, respectively, in comparison with the controls. Reduced proliferative response of splenocytes to various stimuli and suppressed splenic NK activity, as well as decreased macrophage-mediated cytotoxicity, were also found in the mice exposed to social isolation. Thus, these results suggest that social isolation stress enhances tumor metastasis in part via its suppressive effect on the immune system of the host.
High rates of medical morbidity have been reported in subjects with posttraumatic stress disorder (PTSD). The authors examined immune function in subjects in remission from past PTSD.
The initial study group was composed of 1,550 Japanese male workers. Japanese versions of the Events Check List, the Impact of Event Scale-Revised, and the Diagnostic Interview Schedule for DSM-IV were used to identify subjects who had a past history of PTSD. Twelve of the workers were identified as having such a history. These men were matched in age and smoking habits, which affect immunity, to 48 comparison subjects who had similar stressful life experiences but no current or past history of PTSD. Natural killer (NK) cell activity, lymphocyte subset counts, and production of interferon gamma (IFN-gamma) and interleukin-4 (IL-4) were measured in the 60 men by means of phytohemagglutinin stimulation.
The number of lymphocytes, number of T cells, NK cell activity, and total amounts of IFN-gamma and IL-4 were significantly lower in the 12 men with a past history of PTSD.
PTSD leaves a long-lasting immunosuppression and has long-term implications for health.
This report summarizes data from social confrontations studies in laboratory rats dealing with the effects of psychosocial stress on immune functioning and tumor metastasis. The paper focuses on the physiological alterations observed in subdominant males after 2 days of continuous social confrontation. A significant loss of body mass and elevated plasma concentrations of adrenal hormones in subdominant males indicate a stressful social environment. Subdominant males showed lower numbers of blood CD4 and CD8 T cells as well as reduced activity levels of T cells and natural killer (NK) cells relative to control subjects. In order to evaluate the possible health impact of suppressed NK functioning, we used the MADB 106 tumor model. A 10-fold lower tumor clearance in subdominant males demonstrates suppression of the animals' capacity to prevent metastatic development. The relationship between individual behavior and immunological outcome is briefly discussed. Together, the study of male rats in social confrontations appears to be a good model to investigate stress-induced immune modulation and tumor metastasis under relatively naturalistic social conditions.
Advances in the area of cancer prevention and early detection are being made constantly. Basic epidemiologic research continues to provide insight into the impact of carcinogen exposure and the development of cancer. It is exciting to note that the study of Tamoxifen and Raloxifene chemoprevention trial is successfully recruiting women, including minority women, to participate. This large chemoprevention trial is providing much insight into how to recruit and retain women to take a chemoprevention agent to ultimately prevent the development of cancer. Advances also are being made in the knowledge base of how to best detect cancer in asymptomatic people. The best screening tool recommendation for the early detection of colorectal cancer remains controversial. Screening for colorectal cancer, however, is the only way to ultimately decrease the morbidity and mortality associated with the disease. Oncology nurses need to accurately risk for colorectal cancer and provide patients with the necessary information to make an informed choice about the most appropriate screening for their situation. Oncology nurses need to be familiar with new research and advances in cancer prevention and early detection so they can share information with patients and their families.
Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions.
An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials.
Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies.
There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.
Human immunodeficiency virus (HIV)-infected women are at risk for cervical intraepithelial neoplasia (CIN) and cancer due to impaired immunosurveillance over human papillomavirus (HPV) infection. Life stress has been implicated in immune decrements in HIV-infected individuals and therefore may contribute to CIN progression over time. The purpose of this study was to determine whether life stress was associated with progression and/or persistence of squamous intraepithelial lesions (SIL), the cytologic diagnosis conferred by Papanicolaou smear, after 1-year follow-up among women co-infected with HIV and HPV.
Thirty-two HIV-infected African-American and Caribbean-American women underwent a psychosocial interview, blood draw, colposcopy, and HPV cervical swab at study entry. Using medical chart review, we then abstracted SIL diagnoses at study entry and after 1-year follow-up.
Hierarchical logistic regression analysis revealed that higher life stress increased the odds of developing progressive/persistent SIL over 1 year by approximately seven-fold after covarying relevant biological and behavioral control variables.
These findings suggest that life stress may constitute an independent risk factor for SIL progression and/or persistence in HIV-infected women. Stress management interventions may decrease risk for SIL progression/persistence in women living with HIV.
Oxidative stress may contribute to the pathophysiology of many chronic diseases. Since psychosocial stress increases oxidative stress, we conducted an exploratory study to investigate the effects of stress reduction with the Sudarshan Kriya (SK) program, on superoxide dismutase (SOD), catalase, glutathione and blood lactate levels in practitioners and non-practitioners of SK. Blood samples of ten practitioners of SK and 14 non-practitioners of any formal stress management technique were analyzed for SOD, catalase, glutathione and lactate levels. Differences between groups and subgroups were analyzed by t-test and correlations between variables compared using Pearson's correlation coefficient. Significantly lower levels of blood lactate (P=3.118e-10) and higher levels of SOD (P=0.0001415), glutathione (P=2.038e-06) and catalase (P=0.001565) were found in practitioners as compared to non-practitioners of SK, thereby suggesting that lower levels of blood lactate and better antioxidant status in practitioners are associated with regular practice of SK technique. However, this study needs to be conducted on a larger sample size to confirm this effect.
Bupropion sustained release (bupropion SR) has been shown to increase smoking cessation success rates in the US studies.
To determine whether bupropion SR, in combination with counselling, is effective for smoking cessation in a multi-country study.
This randomized, double-blind, placebo-controlled trial enrolled 707 smokers. A total of 527 received bupropion SR 300 mg daily for 7 weeks and 180 received placebo. A total of 11 clinic visits and 10 telephone contacts were scheduled, during the course of 1 year. Seven-week and 12-month abstinence rates were the study outcomes.
Both continuous and weekly point prevalence smoking abstinence rates were significantly higher in the bupropion SR group compared with placebo. The continuous abstinence rate from weeks 4 to 7 was 46% in the bupropion SR group compared with 23% in the placebo group [odds ratio (OR) = 2.82; 95% confidence interval (CI) 1.89-4.28; P < 0.001). At month 12, the continuous abstinence rates were 21% for the bupropion SR group and 11% for the placebo group (OR = 2.19; 95% CI 1.29-3.86, P = 0.002). For most nicotine-withdrawal symptoms small changes were measured. Adverse events were higher for the bupropion SR group compared with placebo (insomnia 24% vs. 15%; dry mouth 13% vs. 5%).
Bupropion SR in combination with counselling increased the abstinence rate compared with placebo, and was well tolerated.
The number of deaths per year from hepatocellular carcinoma (HCC) exceeds 250000, placing it sixth as the cause of death from cancer worldwide. The primary etiology of most cases of HCC in the US is hepatitis B and/or C. Extensive research has demonstrated that the relationship between hepatitis B infection and the progression to HCC is mediated by the immune system. A substantial, but unrelated literature, describes the relationship between psychosocial factors (e.g., stress, psychiatric morbidity), immune system reactivity, and disease progression in patients with cancer. However, the role of these factors in the progression of HBV-HCC has not been explored. An understanding of the relationship among virology, immunology, and behavior in the development and recurrence of HCC may provide alternative methods for secondary prevention of HCC (e.g., behavioral) until a vaccine and/or pharmacological treatments are developed, feasible, and affordable.
It is widely accepted based on volunteer studies that levels of psychological distress are similar in those with functional gastrointestinal (GI) disorders and health in the community, while increased psychological distress in outpatients is largely explained by health-care seeking.
To determine if psychological distress, life event stress, or social support is associated with functional GI disorders in a population-based study.
A nested case-control study was performed by first mailing a self-report bowel disease questionnaire to a random sample of Olmsted County, Minnesota, aged 20-50 yr. All persons who reported symptoms of nonulcer dyspepsia (NUD) or irritable bowel syndrome (IBS) (cases), or an absence of GI symptoms (controls), were invited to complete a series of validated questionnaires designed to measure psychological distress, life event stress, social support, current symptoms, and physician visits.
103 subjects with functional GI disorders and 119 controls participated (85% of eligible). Functional GI disorders were more likely to be reported by those with higher scores on each of the nine SCL-90-R scales used to measure psychological distress (except phobic anxiety), and those with more negative and total life event stress. In a multiple logistic regression model (including age and gender), somatization, interpersonal sensitivity, and total life event stress were independently associated with functional GI disorders. Findings were similar when subjects with the IBS and NUD were analyzed separately compared to controls.
Contrary to current dogma, psychosocial factors were significantly associated with functional GI disorders in this community sample. This suggests that these factors may be involved in the etiopathogenesis rather than just driving health-care utilization.
This study was designed to assess the effect of controlled deep breathing on smoking withdrawal symptoms. In two laboratory sessions, dependent smokers refrained from smoking for 4 h. During a deep breathing session, participants were instructed to take a series of deep breaths every 30 min. During a control session, participants sat quietly. Controlled deep breathing significantly reduced smoking withdrawal symptoms, including craving for cigarettes and negative affect (tense, irritable), while resulting in the maintenance of baseline arousal (wide awake, able to concentrate) levels. Furthermore, a history of heavy smoking was associated with greater increases in arousal during the deep breathing session. The results of this preliminary study suggest that controlled deep breathing may be useful for relieving symptoms of smoking withdrawal.