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The need for effective population mental health promotion approaches is urgent as mental health concerns are escalating globally and current allopathic treatment regimens are insufficient to bring people towards the state of mental well-being (citation). Successfully alleviating stress has the potential to promote wellbeing and prevent illness. Worldwide, yoga is gaining popularity as an accessible, acceptable and cost-effective practice for mind and body. People are turning to yoga for mental health improvement because of preferences for: self-treatment as opposed to clinical intervention; perceived greater efficacy than medication; fewer side effects; lack of response to medication. Yoga has minimal side effects and is cost-effective in comparison with pharmacological treatments and psychotherapy. Yoga’s added benefit is that it improves physical fitness and encourages self-reliance. In this brief article we discuss the evidence for yoga as a form of mental health promotion, illness prevention and treatment for depression.
Yoga and Mental Health: A Review
Farah M Shroff * and Mani Asgarpour
Department of Family Practice and the School of Population and Public Health, The University of British Columbia, Canada
*Corresponding author: Farah M Shroff, Department of Family Practice and the School of Population and Public Health, The University of British Columbia, Canada,
Tel: +6046823269; E-mail:
Received date: April 21, 2016; Accepted date: March 10, 2017; Published date: March 16, 2017
Copyright: © 2017 Shroff FM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.
The need for effective population mental health promotion approaches is urgent as mental health concerns are
escalating globally and current allopathic treatment regimens are insufficient to bring people towards the state of
mental well-being (citation). Successfully alleviating stress has the potential to promote wellbeing and prevent
illness. Worldwide, yoga is gaining popularity as an accessible, acceptable and cost-effective practice for mind and
body. People are turning to yoga for mental health improvement because of preferences for: self-treatment as
opposed to clinical intervention; perceived greater efficacy than medication; fewer side effects; lack of response to
medication. Yoga has minimal side effects and is cost-effective in comparison with pharmacological treatments and
psychotherapy. Yoga’s added benefit is that it improves physical fitness and encourages self-reliance. In this brief
article we discuss the evidence for yoga as a form of mental health promotion, illness prevention and treatment for
Keywords: Mental wellbeing; Quality of life; Yoga; Depression;
Mental health promotion
By 2020, the World Health Organization predicts that depression
will be the second largest contributor to the global disease burden,
aer ischemic heart disease (cite). Anxiety is also being diagnosed at a
greater rate than it was in the past. Despite these increases in diagnosis,
treatment regimens typically include pharmaceutical therapies that are
not sucient to prevent further illness or promote mental well-being.
Eectively addressing mental health concerns entails a comprehensive
approach that addresses the root of the problem(s) [1-3].
In this paper, we provide evidence for yoga as a form of health
promotion, illness prevention and treatment for depression and other
mental health imbalances. Like other therapies, yoga is not a complete
solution to mental health concerns. In conjunction with other
approaches, yoga has great potential to lead people towards greater
mental well-being.
What is Yoga?
e eight limbed path of yoga includes: Yama (moral codes),
niyama (self-discipline), asana (postures), pranyama (breath practices
promoting life force), pratyahara (sensory transcendence), dharana
(concentration), dhyana (meditation), samadhi (state of bliss). e
word roots of yoga mean “to joinin Sanskrit. Joining mind and body,
and individual and collective selves is the essence of this ancient South
Asian practice [4]. Yogic philosophy posits that every life form is
interconnected and united [5]. “Yoga exists in the world because
everything is linked” [6].
Yoga’s greatest aim is to create compassion within and a deep sense
of unity and oneness with all forms of life [7]. Yoga is an individual
activity that has social implications. ose who regularly participate in
yoga typically interact with the world in calmer and more reasonable
ways. More positive social interactions and relationships are one of the
ripple eects of individual yoga practice. Accessible or complementary
yoga classes oer low income people the opportunity to experience the
benets of inner peace and healthier body. When practices such as
yoga are accessible to all, larger eects are possible. Without overstating
the impacts, potential consequences of large scale population mental
well-being initiatives such as this are less violence in society, less
addiction, greater ability to be authentic with one and others.
Literature Review of Mental Health and Yoga Methods
We found approximately 30 review articles and 300 separate studies
in the area of yoga and mental health in the peer-reviewed medical
literature. Because this is a relatively new area of research, it is dicult
to compare one study to the next partly because of sample size
variation, dierences in trial length, and variances in the kind of yoga.
Some studies tested Iyengar (primarily asanas) while others tested
Sudarshan kriya (patterned pranayam exercises, moving from slow and
calming to rapid and stimulating, followed by emotional self-
expression in a supine position), savasana (deep relaxation), Sahaja
yoga (a type of meditation), or pranayam. Varying time periods, from
2 week to 6 months of yogic interventions, also made studies dicult
to compare and contrast. Overall, studies of yoga and mental health
would improve from greater methodological rigor, particularly better
randomization [8].
A brief summary of peer-reviewed literature on yoga and
mental health
As the Patanjali Sutras notes: “Yoga is the practice of quieting the
mind” [9]. Positive mental health is “a state of well-being in which
every individual realizes his or her own abilities, can cope with the
normal stresses of life, can work productively and fruitfully, and is able
to make a contribution to his or her community [10]”. We searched for
articles that examined yoga as a form of promoting mental wellbeing
for healthy people. However most of the literature in this area focuses
Journal of Physiotherapy & Physical
Rehabilitation Shroff and Asgarpour, Physiother Rehabil 2017, 2:1
DOI: 10.4172/2573-0312.1000132
Mini Review OMICS International
Physiother Rehabil, an open access journal
Volume 2 • Issue 1 • 1000132
on improving quality of life for people with cancer and other
aictions. e literature on mental health and yoga is biased towards
individualized mental health imbalances in a similar way as literature
in physical health is biased towards individualized disease.
We found approximately 30 review articles (2002-2014) on yoga as a
treatment for various mental health disorders, including Major
Depressive Disorder (MDD), Anxiety Disorders, Obsessive
Compulsive Disorder (OCD), Schizophrenia and others. e most
signicant results were for yoga as treatment for depression. More
research is required for conclusive evidence-based recommendations;
so far, peer-reviewed literature appears promising for yoga as mental
health promotion and treatment particularly for depression.
Studies of yoga’s eects on quality of life and depression
Yoga has been shown to enhance quality of life in people who are
healthy and ill. A review study found that yoga is as eective or better
than exercise at improving a variety of mental and physical health
measures such as stress, quality of life, mood states, heart rate
variability, pulmonary function and so on [11]. A meta-analysis
concluded that because weight gain and toxicity are side eects of
various pharmacotherapies, yoga may be an eective and less toxic
auxiliary treatment for severe mental illness [12]. In one study yoga
improved subjective wellbeing, mental health and executive
functioning within prison populations [13]. Yoga improved the quality
of life of pregnant women in various studies and enhanced their
interpersonal relationships [14]. Studies over the past 15 years have
shown that yoga can improve psychological health during breast
cancer treatment [15], as well as health-related quality of life in
antipsychotic-stabilized patients [16].
In the treatment of mild to moderate MDD, promising results
indicate that yoga may be applied as a monotherapy [3]. Level Two
evidence supports the use of yoga as an adjunctive therapy [17].
Multiple studies conclude that: a) Yoga is better than no treatment in
improving mild to moderate depressive symptoms in MDD [18]; b)
Yoga is equally as eective as TCAs (tricyclic antidepressants) in severe
MDD [19]; c) Yoga in combination with anti-depressants is better than
anti-depressants alone for depressive symptoms [20].
Patients’ Experiences with Yoga
Connectedness and shared experience with others
“e shared experience was important for coping shared
consciousness was there, when everyone was there together it makes
you feel a feeling of connectedness of everything. You walk out of there
feeling in touch with the condition of others, not just what’s going on
with me, but what’s going on with everything, which is very reassuring.
When you’re in a depressed state, you feel very alone but feeling whole
and part of a whole is where the value is really is.
Coping with stress and ruminations
“I feel good about myself more oen than before the yoga. I learned
to focus on the positive, instead of what I did wrong, didn’t do, or can’t
do anything about anyway.”
Empowerment and competence
“It gives me motivation to try other things that I might not have
tried before it gave me a sense that ‘I can do it, I can do this for myself.
How Does Yoga Work?
e mechanisms that make yoga a seemingly eective health
promotion, disease prevention, treatment, rehabilitation, and palliation
intervention are not entirely understood. Various researchers
hypothesize that yoga works through positively aecting the nervous
system, the cardiovascular system and gene expression. Stimulation of
the vagal nerve results in increased parasympathetic activity of the
autonomic nervous system and also increases GABA (a
neurotransmitter) activity in the brain [21]. Similar to other forms of
physical exercise, breathing and body movement has a positive impact
on cardiovascular health. Studies comparing gene expression in long
term practitioners of yoga with controls suggest that yoga positively
aects gene expression proles in immune cells [22].
From a yogic perspective, the breath is a bridge between mind and
body. Slow diaphragmatic breathing is common to almost all forms of
yoga. e key to quieting the mind is slowing and deepening the
breath. Practicing yoga helps to regain mental stability, calmness, and
tranquility, primarily because of this kind of breathing. Practitioners
are able to connect internally through this stillness and silence.
Virtually all yogic practices, including asana (postures), pranyam (life
force practices), dhyana (meditation), encourage quietness and
listening within. Being kinder and gentler to oneself and others is part
of the practice on and o the mat.
A yogic saying states that through a exible body we gain a exible
mind. is helps people become more patient, forgiving, less prone to
anger and sadness. Additionally, yoga brings practitioners “home” to
their natural selves, partially through an imitation of nature. Many of
the asanas imitate animals and plants such as tree pose, dog pose, cat
pose, snake pose, and others [23].
e nal part of a yoga class is savasana, corpse pose, in which
people lie down with their arms and legs open in deep rest. It is oen
the most popular part of the class, partly because it comes aer the
body has been moving and working. Ayurvedic physicians recommend
savasana to almost all their patients as a remedy to modern society’s
hectic pace of living. Savasana combines deep breathing with
systematic relaxation of each body part. While some people may fall
asleep during savasana, the intent is to maintain consciousness while
most of the body is resting. e sense of expansion and soness helps
to release attachment to material concerns. While we don’t tend to
discuss this outside of India, the symbolism of savasana as a corpse is
based partly on the notion that the corpse is in complete peace. Within
Indian philosophy death is part of a cycle of life and re-birth. By
allowing the mind and body to imitate death, letting go of all worries
and attachments becomes possible.
Moreover, yoga encourages practitioners to experience an open
heart. Many yogic philosophers consider the entire practice to be about
metaphorically connecting to our hearts. Within the chakra system, the
heart lies in the middle of the seven chakras. Asanas such as arda
chakrasana (back bend), kapotasana (pigeon pose), and ustrasana
(camel pose) encourage the expansion of the center of the chest which
is the location of the anahata chakra, the yogic heart center.
Visualizations and pranyams in yoga also encourage open heartedness.
e eect is oen less judgment, greater acceptance of self and others
and a more relax approach to life.
Citation: Shroff FM, Asgarpour M (2017) Yoga and Mental Health: A Review. Physiother Rehabil 2: 132. doi:10.4172/2573-0312.1000132
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Volume 2 • Issue 1 • 1000132
e practice of yoga shows promise for promoting better population
mental health. It is acceptable, accessible, cost-eective and encourages
self-reliance. Yoga is an individual health promoting practice that can
be done in groups and supported by communities. Like other holistic
practices such as tai chi, qigong, meditation and so forth, it includes a
community component. Practicing yoga together, in workplaces,
schools and other group settings have shown to promote population
mental health [24]. While yoga does not address the social
determinants of mental illness it does promote a greater sense of inner
peace for those who partake.
It appears that deep slow breathing in combination with movement
and other aspects of yoga are at the heart of yoga’s ability to bring
people a greater sense of tranquility. It meets the triple aim of
improving health, improving care and reducing cost. A recent article
questions whether sucient evidence exists for family physicians to
recommend yoga to their patients. e evidence-based answer: “Yes,
yoga can reduce symptoms of anxiety and depression (strength of
recommendation [SOR]: B, systematic reviews of randomized
controlled trials [RCTs] with signicant heterogeneity). Across
multiple RCTs using varied yoga interventions and diverse study
populations, yoga typically improves overall symptom scores for
anxiety and depression by about 40%, both by itself and as an
adjunctive treatment. It produces no reported harmful side eects.” In
some cases yoga is taught for free such as yoga clubs in India and other
countries. While it may not be for everyone, through a disciplined
approach most people with or without mental health imbalances may
feel more mental ease and relaxation through the practice of yoga.
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Citation: Shroff FM, Asgarpour M (2017) Yoga and Mental Health: A Review. Physiother Rehabil 2: 132. doi:10.4172/2573-0312.1000132
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Volume 2 • Issue 1 • 1000132
... As an accessible and economical practice for mind and body, Yoga is gaining high reputation worldwide. Yoga is for many people an individual health promoting practice, but practicing Yoga in a class has shown to promote group related behavior as well (Shroff & Asgarpour, 2017). ...
... In other words, Yoga classes provide an opportunity, which includes physical, psychological and social aspects. Furthermore, Yoga can be used as a form of mental health promotion, illness prevention and treatment of depression (Shroff & Asgarpour, 2017); fitting in the framework of salutogenesis. ...
... 143 . Furthermore, Yoga can be used as a form of mental health promotion, illness prevention and treatment of depression (Shroff & Asgarpour, 2017) all in sum preventive tackling the problem of insufficient PA (Antonovsky, 1979;Belz et al., 2020;. ...
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Objective. The purpose of this study was to determine social identification effects which support extensive PA behavior (i.e., adherence) and the impact self-efficacy has on this relationship. Design. This study used a quantitative cross-sectional research approach in using numerical analysis to measure the psychosocial phenomena of social identification and self-efficacy via questionnaires from participants (N = 99) recruited directly after Yoga classes in a gym and a longitudinal measurement of adherence via attendance reports from instructors. Results. A predictive model with a high level of fit and high effect size (R2 = .31, f2 = .45) of individuals’ PA participation behavior in Yoga classes considering social identification and self-efficacy as predictors could be revealed. Significant correlations between social identity’s dimension and the sources of self-efficacy could be found in regard of ingroup ties, cognitive centrality, and ingroup affect as well as vicarious experience, verbal and self-persuasion, and positive affective states. No mediation effect of self-efficacy on the relationship between social identity and adherence was found. Conclusion. The results revealed that not only the personal ability of exercising Yoga leads to regular participation but rather the interaction with others and the social experience people gain by being physically active together. Therefore, fostering social identification and self- efficacy beliefs may provide an actionable framework for exercise (e.g., Yoga) instructors to support individuals’ adherence and thus a healthy lifestyle.
... We found 30 review articles (2002-2014) on yoga as a treatment for various mental health disorders, including Major Depressive Disorder (MDD), Anxiety Disorders, Obsessive Compulsive Disorder (OCD), Schizophrenia and others. The most significant results were for yoga as treatment for depression165 . Yoga has revealed to improve quality of life in healthy or sick people. ...
Objective: We intended to evaluate the efficacy of yogic exercise on cardio-respiratory fitness; memory, stress, mental health and plasma nitric oxide level in healthy adult subjects. We also aimed to find out the correlation between change in cardiorespiratory fitness & mental health and nitric oxide level due to yoga practice. Methods: In this yoga interventional study, the most prevalent yoga exercise model (Asanas, Pranayama and Meditation) was used. The study samples (n=200) were healthy male (n=120) and female (n=80) adults (mean age=39.95 years) were recruited by taking written consent. Subjects with any systemic and/or psychological disorders or under specific medications, pregnant women were excluded. Subjects who have never practiced or practicing yoga or other type of physical exercise and willing to practice yoga (1 hr per day; 6 days per week for 6 months) were included in the study. Data was collected at baseline (pre-yogic exercise) and after 6-months of yoga training (post-yogic exercise). The following parameters were measured at baseline and after yoga practice for 6 months: Cardio-respiratory parameters and fitness: Resting HR, resting BP, HR and BP after Harvard Step Test (HST), vital capacity, FEV1, PEFR, VO2max, physical fitness index (PFI); Mental health: memory, perceived stress (PSS), anxiety, depression, emotional balance, loss of behavioral or emotional control, general positive affect, life satisfaction, psychological distress & well-being, mental health index (MHI); and plasma nitric oxide level (NOx). The collected data was statistically analyzed with SPSS (24th version). Paired t-test was applied to determine the significance difference between baseline and post-yogic data values. The p-value was established at 5% level of significance. vii Results: We found significant decrease in resting heart rate (p<0.0001) and resting SBP and DBP (p<0.0001); significant increase vital capacity (p<0.0001), FEV1 (p<0.0001), PEFR (p<0.0001) and increase in VO2max (p<0.0001) by 14.43%, NOx (p<0.001) after yoga regimen. We found significant increase (p<0.0001) in physical fitness index by 56%. Yogic exercise for 6 months resulted in significant increase in memory score ((p<0.0001) and significant reduction in perceived stress score (PSS); anxiety (p<0.0001), depression (p<0.0001), and loss of behavioral or emotional control (p<0.0001) and psychological distress (p<0.0001) scores. Further, we found significant increase in general positive affect (p<0.0001), emotional ties (p<0.0001), life satisfaction (p<0.0001) scores. Regular practice of yoga for 6 months have resulted in significant increase in mental health index (p<0.0001). Conclusion: Significant improvement in cardio-respiratory fitness and mental health due to yoga practice suggests the extremely positive health benefits on physiological as well as psychological health. The results indicate the effectiveness of yoga as mind and body work out modality to improve the cardio-respiratory and mental health, if practiced regularly.
... The aerobic component helps to activate the central nervous system, which regulates the production of clinical biomarkers responsible for relieving symptoms of depression and post-traumatic stress disorder. 9 Whereas, regular practice of meditative techniques relaxes parasympathetic system reducing anxiety and mood disorders. Meditative techniques of Hatha Yoga and Sudarshan kriya are known to manage stress and negative emotional states and restore mental balance in these patients. ...
Medically unexplained physical symptoms (MUPS) is a common, yet neglected disease with a prevalence of around 25% in primary care setting. These patients present with multiple physical and psychological symptoms, without an underlying diagnosis, hampering their functional and mental wellbeing. The management of these undiagnosed symptoms through conventional treatment has not been encouraging. Patients shuttle between different specialities, seeking a diagnosis for their symptoms, making them dissatisfied and increasing healthcare burden. Yoga, as an adjunct therapy has shown to be effective in the management of MUPS related disorders such as somatoform disorder, irritable bowel syndrome (IBS) and depression and anxiety. Thus, we suggest an integrated yoga module which might help in improving both physical and psychological variable in MUPS patients and improving their overall quality of life. Furthermore, the gap in the literature on the efficacy of yoga in improving MUPS, can be addressed by planning a randomised controlled trial based on the suggested yoga module.
... Yoga practice has experienced significant growth in recent decades across numerous health disciplines and is generally considered a viable treatment for a variety of mental health conditions (Bussing, Michalsen, Khalsa, Telles, & Sherman, 2012;Kirkwood, Rampes, Tuffrey, Richardson, & Pilkington, 2005;Louie, 2014;Shroff & Asgarpour, 2017). YB, which is also known as pranayama in yoga practice, is the procedure of manipulating breath for achieving specific results. ...
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Breathwork techniques and therapies offer a set of practical interventions for clinical mental health counselors (CMHCs) and are viable methods for integrating physiological sensitivities in treatment by way of the relaxation response. We discuss an organizing framework of breathwork practices and identify three broad categories of breathwork within the field: deep relaxation breathing, mindfulness breathwork, and yogic breathing. Each style is distinct in how it is applied and in the specific respiratory patterns that users are instructed to use. We also aim to elaborate the physiological effects, clinical research outcomes, and applicability of breathwork for treating mental illness. Overall, research findings indicate that breathwork may be efficacious for treating anxiety, depression, and posttraumatic stress disorder. Despite preliminary evidence for breathwork's efficacy for treating common psychological distress, more research is needed to evaluate its utility for treating a wider range of mental illness. CMHCs are encouraged to incorporate breathwork techniques in their clinical treatment programs but must appraise the value of each technique individually.
COVID19 pandemic is global infectious disease caused by SARS Corona Virus 2. The pandemic so far has affected more than 200 countries and territories causing more than 12,552,765 human infections and 561,617 human deaths. The situation has created global emergency crisis and is rapidly spreading. The infected humans are known to have low immunity and once infected developed conditions such as acute respiratory distress syndrome, breathlessness, severe dyspnea, tachypnea, respiratory distress, hypoxia and cardiac arrest, etc. In addition, people with chronic diseases like diabetes, hypertension, cardiovascular disorders, Chronic obstructive pulmonary disorder (COPD), asthma, and elderly people with weakened immune systems are known to be more prone to catch the infection. So far no treatment is clinically proven and available, but many are under investigations; the best approach to fight against the disease is prevention and management of COVID19 infection. Yoga, meditation, and yogic bio-cleansing practices previously evidenced for general immune boosting capacity, and are also evidenced for the management of respiratory disorders, non-communicable disorders such as diabetes, cardiovascular diseases, etc, and also for psychological disorders and ailments; by reviewing these studies, in the presented study, it was attempted to shed a light on the possibility of supporting role of Yoga for improving physical and mental health in the patients with COVID19 with respiratory disorders, co-morbidities (diabetes and cardiovascular disorders), decreased immune function, and psychological illness.
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Background: Yoga and meditation have been shown to be effective in alleviating symptoms of depression and anxiety in healthy volunteers and psychiatric populations. Recent work has also indicated that yoga can improve cognitive-behavioural performance and control. Although there have been no controlled studies of the effects of yoga in a prison population, we reasoned that yoga could have beneficial effects in a setting where psychosocial functioning is often low, and the frequency of impulsive behaviours is high. Methods: Participants were recruited from 7 British prisons and randomly allocated to either a 10-week yoga programme (yoga group; 1 class per week; N = 45) or a control group (N = 55). Self-report measures of mood, stress, and psychological distress were collected before and after the intervention period. Participants completed a cognitive-behavioural task (Go/No-Go) at the end of the study, which assessed behavioural response inhibition and sustained attention. Results: Participants in the yoga group showed increased self-reported positive affect, and reduced stress and psychological distress, compared to participants in the control group. Participants who completed the yoga course also showed better performance in the cognitive-behavioural task, making significantly fewer errors of omission in Go trials and fewer errors of commission on No-Go trials, compared to control participants. Conclusions: Yoga may be effective in improving subjective wellbeing, mental health, and executive functioning within prison populations. This is an important consideration given the consistently high rates of psychological morbidity in this group and the need for effective and economical intervention programmes.
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The concept of holism is defined in disparate ways. This article offers foundational understandings of this term from various parts of the world, illustrating the virtually universal, historical, as well as contemporary nature of ideas such as interconnectedness, unity and oneness. Throughout human history, holistic worldviews were dominant until the past 400 years or so. At present, a revival of holistic thought-forms is taking place in many parts of the world. The purpose of this article is to sketch the landscape of holistic philosophical foundations, discuss systems science in this context and apply these underpinnings to holistic health in the hope that it will increase our understanding of both the conceptual foundations of holism, as well as its applications to health promotion, disease prevention, treatment of ill health and palliation. The article will conclude with the recommendation that holistic health-care practitioners take social inequities into account, so that this integrative health-care can become a means for individuals to take action for wellness, as well as a means to create structural changes toward equitable resource distribution.
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Abstract Background Many breast cancer patients and survivors use yoga to cope with their disease. The aim of this review was to systematically assess and meta-analyze the evidence for effects of yoga on health-related quality of life and psychological health in breast cancer patients and survivors. Methods MEDLINE, PsycInfo, EMBASE, CAMBASE, and the Cochrane Library were screened through February 2012. Randomized controlled trials (RCTs) comparing yoga to controls were analyzed when they assessed health-related quality of life or psychological health in breast cancer patients or survivors. Risk of bias was assessed using the Cochrane risk of bias tool. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Results Twelve RCTs with a total of 742 participants were included. Seven RCTs compared yoga to no treatment; 3 RCTs compared yoga to supportive therapy; 1 RCT compared yoga to health education; and 1 RCT compared a combination of physiotherapy and yoga to physiotherapy alone. Evidence was found for short-term effects on global health-related quality of life (SMD = 0.62 [95% CI: 0.04 to 1.21]; P = 0.04), functional (SMD = 0.30 [95% CI: 0.03 to 0.57), social (SMD = 0.29 [95% CI: 0.08 to 0.50]; P
SUMMARY This paper provides a critical look at the challenges facing the field of health promotion. Pointing to the persistence of the disease orientation and the limits of risk factor approaches for conceptualizing and conduct- ing research on health, the salutogenic orientation is presented as a more viable paradigm for health promo- tion research and practice. The Sense of Coherence framework is offered as a useful theory for taking a salutogenic approach to health research.
Integrative medicine (IM) approaches have gained significant interest in recent years to provide a solution for the health care challenges we face today. Yogic cognitive-behavioral practices are among the most widely used IM approaches and include diverse practices such as yoga asanas, meditation, breathing exercises, Qi Gong, Tai Chi Chih, and various others. Studies to date suggest that these yogic/meditative practices have significant positive effects on the mind-body system and thereby can increase wellness and support the healing process from disease. Previous work has provided evidence for both psychological and physiological effects of these practices; however, the mechanisms of these effects, especially at the molecular level, have largely been missing. Three recent studies started to provide some of this information through gene expression profiling in circulating immune cells, which support the hypothesis that yogic/meditative practices have a measurable effect at the molecular level. These studies are reviewed herein and some future perspectives are considered.
Eyes closed, back tall, legs folded, we connected—strangers yesterday, friends today. We‟re All One! Each member of the human family is a variation of the one. In yoga we know the teachings about this unity of all life forms and after traveling for one and a half years it means so much more to me. The lessons of yoga, profound and beautiful, were illustrated in each yoga class in many parts of the world. Our family of two adults and two kids traveled the world for 18 months recently and I taught yoga to many new friends along the way--in the Republic of Georgia, Germany, Norway, Sweden, Turkiye, Cyprus, Syria, Jordan, Egypt, India, Bulgaria and elsewhere. As we visited many places where yoga was unknown, I was often people‟s first yoga teacher. What an honor, to be the ambassador of this beautiful practise and witness the sweet tranquility that yoga brings to people‟s faces and bodies. I am continually in awe of yoga‟s ability to reach people at a deep level, even without shared (verbal) language. I was teaching people whose language was Arabic, Georgian, Mahrati, Turkish and so on, and these are not languages I speak.
Patient use of complementary and alternative treatments, including yoga, to manage mood and anxiety disorders, has been well documented. Despite research interest, there are few recent reviews of the evidence of the benefit of yoga in these conditions. The PubMed, Medline and PsycInfo databases were searched for literature published up to July 2008, relating to yoga and depressive and anxiety disorders. The paucity of reported studies and several methodological constraints limit data interpretation. In depressive disorders, yoga may be comparable to medication and the combination superior to medication alone. There is reasonable evidence for its use as second-line monotherapy or augmentation to medication in mild to moderate major depression and dysthymia, with early evidence of benefit in more severe depression. In anxiety disorders, yoga may be superior to medication for a subgroup of patients, but its benefits in specific conditions are still largely unknown. Second-line monotherapy is indicated in performance or test anxiety, but only preliminary evidence exists for obsessive-compulsive disorder and post-traumatic stress disorder. Yoga appears to be superior to no treatment and progressive relaxation for both depression and anxiety, and may benefit mood and anxiety symptoms associated with medical illness. It shows good safety and tolerability in short-term treatment. Reasonable evidence supports the benefit of yoga in specific depressive disorders. The evidence is still preliminary in anxiety disorders. Given its patient appeal and the promising findings thus far, further research on yoga in these conditions is encouraged.
The objective of this systematic review was to assess the effectiveness of yoga as a complementary treatment on general psychopathology, positive and negative symptoms and health-related quality of life (HRQL) for people with schizophrenia. Randomised controlled trials (RCTs) were considered whether they investigated a yoga intervention in patients with schizophrenia. The selection of studies, data extraction and quality assessment were performed independently by two reviewers. Only three RCTs met the inclusion criteria. Lower Positive and Negative Syndrome Scale (PANSS) total scores and subscale scores for positive and negative symptoms were obtained after yoga compared with exercise or waiting list control conditions. In the same way, the physical, psychological, social and environmental HRQL as measured with the abbreviated version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) increased more significantly after yoga than after exercise or waiting list control conditions. None of the RCTS encountered adverse events. Dose-response relationships could, however, not be determined. Although the number of RCTs included in this review was limited, results indicated that yoga therapy can be an useful add-on treatment to reduce general psychopathology and positive and negative symptoms. In the same way, HRQL improved in those antipsychotic-stabilised patients with schizophrenia following yoga.
To examine the efficacy of yoga therapy as a complementary treatment for psychiatric disorders such as schizophrenia, depression, anxiety, and posttraumatic stress disorder (PTSD). Eligible trials were identified by a literature search of PubMed/MEDLINE, Cochrane Control Trials Register, Google Scholar, and EBSCO on the basis of criteria of acceptable quality and relevance. The search was performed using the following terms: yoga for schizophrenia, yoga for depression, yoga for anxiety, yoga for PTSD, yoga therapy, yoga for psychiatric disorders, complementary treatment, and efficacy of yoga therapy. Trials both unpublished and published with no limitation placed on year of publication were included; however, the oldest article included in the final meta-analysis was published in 2000. All available randomized, controlled trials of yoga for the treatment of mental illness were reviewed, and 10 studies were eligible for inclusion. As very few randomized, controlled studies have examined yoga for mental illness, this meta-analysis includes studies with participants who were diagnosed with mental illness, as well as studies with participants who were not diagnosed with mental illness but reported symptoms of mental illness. Trials were excluded due to the following: (1) insufficient information, (2) inadequate statistical analysis, (3) yoga was not the central component of the intervention, (4) subjects were not diagnosed with or did not report experiencing symptoms of one of the psychiatric disorders of interest (ie, schizophrenia, depression, anxiety, and PTSD), (5) study was not reported in English, and (6) study did not include a control group. Data were extracted on participant diagnosis, inclusion criteria, treatment and control groups, duration of intervention, and results (pre-post mean and standard deviations, t values, and f values). Number, age, and sex ratio of participants were also obtained when available.Data Synthesis: The combined analysis of all 10 studies provided a pooled effect size of -3.25 (95% CI, -5.36 to -1.14; P = .002), indicating that yoga-based interventions have a statistically significant effect as an adjunct treatment for major psychiatric disorders. Findings in support of alternative and complementary interventions may especially be an aid in the treatment of disorders for which current treatments are found to be inadequate or to carry severe liabilities. As current psychopharmacologic interventions for severe mental illness are associated with increased risk of weight gain as well as other metabolic side effects that increase patients' risk for cardiovascular disease, yoga may be an effective, far less toxic adjunct treatment option for severe mental illness.