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Varambally S, Holla B, Venkatasubramanian G, Mullapudi T, Raj P, Shivakumar V, Christopher R, Debnath M, Philip M, Bharath RD, Gangadhar BN. Clinical effects of a yoga-based intervention for patients with schizophrenia - A six-month randomized controlled trial. Schizophr Res 2024; 269:144-151. [PMID: 38795661 DOI: 10.1016/j.schres.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/08/2024] [Accepted: 05/04/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Yoga has shown promise as an add-on therapy for patients with schizophrenia. However, most studies have been short-term, with methodological limitations. METHODS We conducted a six-month parallel-group randomized-controlled trial (with rater blinding) to evaluate the effectiveness of a yoga-based intervention in improving symptoms and quality of life in patients with schizophrenia. We recruited 110 patients from an urban tertiary hospital and a semi-urban community centre who met DSM 5 criteria for schizophrenia and were on stable medication for at least six weeks. Participants were randomly assigned to either yoga add-on therapy (YT) or treatment-as-usual (TAU) groups. Clinical assessments were conducted at baseline and at one, three and six months. The primary outcome was changes in positive/negative symptom scores and secondary outcomes included changes in quality of life, perceived stress and socio-occupational functioning. RESULTS Intention to treat analysis with a longitudinal mixed model approach revealed a significant group-by-time interaction with the YT group showing medium effect improvements in negative symptoms (η2p = 0.06) and small effect improvements in positive symptoms (η2p = 0.012), WHOQOL-BREF quality of life [psychological well-being (η2p = 0.015) and environmental health (η2p = 0.048)] when compared to TAU. The patients successfully learned and performed yoga practices without reporting any significant adverse effects. DISCUSSION Our findings suggest that yoga-based intervention may be a valuable adjuvant therapy for medication-stabilized patients with schizophrenia, especially in ameliorating negative symptoms and enhancing quality of life. Future controlled trials, including active physical interventions, are crucial to validate yoga's efficacy, optimize clinical use, and elucidate underlying mechanisms.
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Affiliation(s)
- Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Bharath Holla
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Thrinath Mullapudi
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Praveen Raj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Mariamma Philip
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - B N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India; Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Ngubane NP, Mabandla MV, De Gama BZ. Global perspectives on the traditional approaches used in the treatment of schizophrenia: A systematic review. Asian J Psychiatr 2024; 97:104081. [PMID: 38797088 DOI: 10.1016/j.ajp.2024.104081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/01/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Traditional healing considers a holistic approach when diagnosing and treating patients for mental ailments, and is the preferred approach globally. OBJECTIVE This review documented traditional healing approaches for treatment of schizophrenia used in different regions globally. METHODS PICO framework was used to facilitate literature search from Google Scholar, PubMed, Medline, Cochrane, Scopus, APA PsycINFO, and Web search. Studies documenting methods of treatment from the perspective of traditional healers, patients and/or caregivers were included and also studies which investigated herbal plants used in traditional healing in vitro and in vivo were included. Review articles, magazine/newspaper articles, editorials, letters, comments/opinion articles, and articles with inaccessible full text were excluded. The risk of bias was assessed using MMAT and SYRCLE tools. University Capacity Development Programme funded this review. RESULTS 74 articles were included, these documented traditional healing practices used in Africa, Asia, America, Europe, and Oceania. Common approach globally was herbal medicine. Other reported methods included faith-based healing, consultation with the ancestors, performing rituals, acupuncture, and music and yoga therapies. Inhumane approaches included starving, beating, cutting and confining patients. In some cases, traditional healing was used as adjunctive treatment. The overall risk of bias for studies in this review was low. CONCLUSION Traditional healing contributes in bridging the treatment gap for schizophrenia in developing countries. However, there is a lack of standardisation of the approaches employed in the different regions, and the safety and effectiveness of some of these approaches remain questionable.
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Affiliation(s)
- Ntombifuthi P Ngubane
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban 4000, South Africa.
| | - Musa V Mabandla
- Discipline of Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban 4000, South Africa
| | - Brenda Z De Gama
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban 4000, South Africa
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Venet-Kelma L, Morvan Y, Romain AJ, Mendy M, Meslier M, Thoisy I, Mulin E, Chirio-Espitalier M, Dadi G, Moualla M, Amado I, Kern L. Effect of an adapted physical activity program on stress, anxiety, depression in patients with schizophrenia: study protocol of a randomized-controlled trial. Eur Arch Psychiatry Clin Neurosci 2024; 274:891-902. [PMID: 37670161 DOI: 10.1007/s00406-023-01689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Abstract
Physical activity (PA) is recommended to optimize well-functioning in people with schizophrenia. PA has been found to improve quality of life, general symptomatology, depression, anxiety and stress symptoms, global and social functioning. In PA research, most of the interventions are based on one-on-one interventions but there is poor information about group-based PA interventions. Using a randomized controlled, clinician-blinded trial, subjects are randomized into two arms: the PA group or control group. Our first objective is about to evaluate the effects of a multimodal 6 week collective PA intervention on depression, anxiety, and stress symptoms in people with schizophrenia. Our second objective is about to evaluate these effects on secondary outcomes especially smoking, well-being, physical fitness and on care utilization. All participants are evaluated before and after the 6 week intervention period, and only participants in the PA group are called in a follow-up interview 3 and 6 months after the intervention.Trial registration Individual Protection Committee of Ile-de-France II, n ID RCB: 2018- A00583-52. Registered on 8 April 2018.
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Affiliation(s)
- Lucie Venet-Kelma
- University of Montreal, Montreal, QC, Canada. lucie.venet--
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada. lucie.venet--
| | | | - Ahmed Jérôme Romain
- University of Montreal, Montreal, QC, Canada
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada
| | - Mauricette Mendy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Marjorie Meslier
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Thoisy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
| | - Emmanuel Mulin
- Korian Val du Fenouillet Psychiatric Clinic, La Crau, France
| | - Marion Chirio-Espitalier
- Reference Center for Therapeutic Education and Cognitive Remediation, University Hospital of Nantes, Nantes, France
| | - Ghita Dadi
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Mona Moualla
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Amado
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Laurence Kern
- University of Paris Nanterre, Nanterre, France
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
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Rißmayer M, Kambeitz J, Javelle F, Lichtenstein TK. Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health. Schizophr Bull 2024; 50:615-630. [PMID: 38394386 DOI: 10.1093/schbul/sbae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND HYPOTHESIS Exercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes. STUDY DESIGN PubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities. STUDY RESULTS Of 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01). CONCLUSIONS A minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.
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Affiliation(s)
- Matthias Rißmayer
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, NeuroPsychoImmunology Research Unit, German Sport University Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Florian Javelle
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, NeuroPsychoImmunology Research Unit, German Sport University Cologne, Cologne, Germany
| | - Theresa Katharina Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Cui W, Liu Z, Liang C, Zhao Z. Comparative efficacy of different types of exercise modalities on psychiatric symptomatology in patients with schizophrenia: a systematic review with network meta-analysis. Sci Rep 2024; 14:7019. [PMID: 38528063 PMCID: PMC10963726 DOI: 10.1038/s41598-024-57081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
This network meta-analysis investigated the effects of 8 types of physical exercises on treating positive symptoms, negative symptoms, general psychopathology, and the Positive And Negative Syndrome Scale (PANSS) total score in patients with schizophrenia. The methods adhered to PRISMA guidelines and used the Cochrane risk of bias tool for quality assessment, and Stata software for data analysis. Data were sourced from PubMed, Embase, Web of Science, and the Cochrane database up to August 15, 2023, following PICOS principles. A total of 25 studies including 1441 participants were analyzed. Results showed that resistance exercise seems to be effective for improving positive symptoms, while Yoga was more effective for negative symptoms. Low-intensity aerobic exercise was optimal for general psychopathology, and Yoga was effective in improving the PANSS total score. The study concluded that yoga and aerobic exercise demonstrated superior performance, but the impact of exercise on patients with schizophrenia is also influenced by individual factors and intervention dosages. Therefore, a pre-assessment of patients considering factors such as interests, hobbies, and physical capabilities is crucial for selecting appropriate exercise modalities.
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Affiliation(s)
- Wenlai Cui
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Zhitao Liu
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian, China
| | - Cheng Liang
- Graduate School, Capital University of Physical Education and Sports, Beijing, China
| | - Zhizhi Zhao
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China.
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Yin J, Sun Y, Zhu Y, Alifujiang H, Wang Y, An S, Huang H, Fu X, Deng H, Chen Y. Effects of yoga on clinical symptoms, quality of life and social functioning in patients with schizophrenia: A systematic review and meta-analysis. Asian J Psychiatr 2024; 93:103959. [PMID: 38342034 DOI: 10.1016/j.ajp.2024.103959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Yoga is gradually being explored as a potential complementary intervention in addition to psychiatric drugs for schizophrenia. However, there are conflicts on the efficacy of yoga for schizophrenia. This meta-analysis was aimed to evaluate the association of yoga intervention with reductions on clinical symptoms and improvements in quality of life (QoL) as well as social functioning among schizophrenia. METHOD Systematic literature search was undertaken to identify all RCTs that compared yoga with active or passive controls for patients with schizophrenia from inception to July 2023. The outcomes were measurements of positive symptoms, negative symptoms, QoL and social functioning. Random-effects models were performed to calculate the effect sizes in the standardized mean differences reporting as Hedges' s g statistic. RESULTS 19 studies enrolling 1274 participants with schizophrenia were included. Yoga had a medium effect on positive symptoms in the short term (Hedges's g = 0.31) and small effect in the long term (Hedges's g = 0.18). Medium significant effects were also found on negative symptoms in both the short term (Hedges's g = 0.44) and the long term (Hedges's g = 0.35). Yoga had a significant impact on improving both total QoL (Hedges's g = 0.34) and social functioning (Hedges's g = 0.45) with medium effect sizes. CONCLUSIONS Yoga was associated with significant reductions on negative and positive symptoms, and significant improvements in QoL as well as social functioning in patients with schizophrenia. Future research should explore the long-term efficacy of yoga for schizophrenia, encompassing more diverse populations.
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Affiliation(s)
- Jingyu Yin
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuqi Sun
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yikang Zhu
- Shanghai Mental Health Center, Shanghai, China
| | | | - Yi Wang
- Mianyang Central Hospital, Mianyang, China
| | - Siyao An
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huiqun Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xi Fu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China; Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Deng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Ying Chen
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
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Su Y, Pan X, Li H, Zhang G. Effects of mind-body therapies on schizophrenia: A systematic review and network meta-analysis. Schizophr Res 2024; 264:236-247. [PMID: 38185028 DOI: 10.1016/j.schres.2023.12.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 12/09/2023] [Accepted: 12/25/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE The objective of this meta-analysis is to evaluate and compare the effectiveness of different mind-body therapies in reducing the symptoms of schizophrenia. METHODS A systematic search was performed using databases such as PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Randomized controlled trials that assessed the effects of mind-body therapies on patients with schizophrenia were included. The search covered the period between the inception of each database and November 17th, 2022. The methodological quality of the trials was assessed using the Cochrane risk of bias tool. A network meta-analysis was conducted to compare the effects of various mind-body therapies, including Yoga, Mindfulness, Tai Chi, Baduanjin, and Yijinjing. RESULTS The analysis included 22 randomized controlled trials involving a total of 2064 subjects. The network meta-analysis revealed that Yoga and Mindfulness interventions were more effective than other mind-body therapies in reducing the symptoms of schizophrenia. Specifically, Yoga improved PANSS-positive symptom scores (SUCRA: 74.8 %) and PANSS-negative symptom scores (SUCRA: 80.4 %), whereas Mindfulness improved PANSS-positive symptom scores (SUCRA: 85.6 %). CONCLUSION The findings of this study indicate that Yoga may be a promising intervention for the treatment of schizophrenia. However, the small sample size and the low quality of the included studies have limited the generalizability of our findings Therefore, this study must be understood with caution, and further investigation is warranted when more relevant studies emerge.
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Affiliation(s)
- Yuqin Su
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China; College of Physical Education, Chongqing University of Posts and Telecommunications, Chongqing, China.
| | - Xiaoli Pan
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Hansen Li
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China
| | - Guodong Zhang
- Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China.
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Bhargav H, Keshavan M. Why and how might yoga differ from other mind-body approaches in schizophrenia? Schizophr Res 2024; 264:479-481. [PMID: 38277737 DOI: 10.1016/j.schres.2024.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Affiliation(s)
- Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, India.
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, United States.
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Yadav J, Bhardwaj A, Jangid P, Singh P, Gupta R. Meditation-A Slippery Slope for Psychosis: A Case Series With Review of Evidence. J Nerv Ment Dis 2023; 211:634-638. [PMID: 37505896 DOI: 10.1097/nmd.0000000000001656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
ABSTRACT The practice of meditation has been traditionally viewed as a self-regulatory approach that aids in psychological well-being. Over the last decade, mindfulness-based meditation has gained a separate therapeutic significance in various mental health conditions. There has also been considerable understanding of the adverse effects of meditation over the years. Despite this, there is still underreporting of the altered behavioral presentations arising possibly because of intensive and unguided meditation practices. We present two cases of meditation-related psychosis with different clinical presentations. The write-up highlights the need for tailoring the meditation practices after evaluation of mental state of the individuals and early detection of "at-risk" mental states. There should be regular screening of emergence of any unwanted effects during the course of meditation and the guides should be able to detect the early warning signs of psychosis.
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Affiliation(s)
- Jagriti Yadav
- Department of Psychiatry, Institute of Mental Health, Pt B. D. Sharma University of Health Sciences, Rohtak, Haryana
| | - Akansha Bhardwaj
- Department of Psychiatry, Hamdard Institute of Medical Sciences & Research, New Delhi
| | - Purushottam Jangid
- Institute of Mental Health, Pt B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Priti Singh
- Institute of Mental Health, Pt B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Rajiv Gupta
- Institute of Mental Health, Pt B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
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Kim M, Lee Y, Kang H. Effects of Exercise on Positive Symptoms, Negative Symptoms, and Depression in Patients with Schizophrenia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3719. [PMID: 36834415 PMCID: PMC9967614 DOI: 10.3390/ijerph20043719] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
This study was performed to evaluate the effects of exercise on positive and negative symptoms and depression in patients with schizophrenia through a systematic review and meta-analysis focusing on randomized controlled trials (RCTs). PubMed, Embase, CINAHL, MEDLINE, Cochrane Library, PsycINFO, and Web of Science were searched from their inception to 31 October 2022. We also conducted a manual search using Google Scholar. This meta-analysis was conducted according to the PRISMA guidelines. The methodological quality of the studies was assessed using the Cochrane risk-of-bias tool for randomized trials. To identify the cause of heterogeneity, subgroup analysis, meta-ANOVA, and meta-regression analyses were performed as moderator analyses. Fifteen studies were included. The meta-analysis (random-effects model) for overall exercise showed a medium significant effect (standardized mean difference [SMD] = -0.51, 95% confidence interval [CI]: -0.72 to -0.31) on negative symptoms, a small significant effect (SMD = -0.24, 95% CI: -0.43 to -0.04) on positive symptoms, and a nonsignificant effect (SMD = -0.87, 95% CI: -1.84 to 0.10) on depression. Our findings demonstrate that exercise can relieve the negative and positive symptoms of schizophrenia. However, the quality of some included studies was low, limiting our results for clear recommendations.
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Affiliation(s)
| | | | - Hyunju Kang
- College of Nursing, Kangwon National University, Chuncheon-si 24341, Republic of Korea
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Isabelinha B, Cruz-Ferreira A, Maximiano J, Almeida G. Effects of body-oriented therapies on the negative symptoms in people with schizophrenia: A systematic review. J Bodyw Mov Ther 2023; 33:189-201. [PMID: 36775518 DOI: 10.1016/j.jbmt.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/11/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
In a stabilized phase of schizophrenia, negative symptoms are evident, on which body-oriented therapies can act. This systematic review examines the scientific evidence of the effects of all body-oriented therapies on the negative symptoms in people with schizophrenia and the effects of each type of body-oriented therapies on the negative symptoms in people with schizophrenia. To carry out this systematic review, the PRISMA guidelines were followed. The research was carried out through Pubmed, Cochrane, Web of Science, APAPsycNet, Science Direct, Scopus and the VHL Regional Portal. The methodological quality of the studies was assessed using the PEDro scale and data synthesis was performed. There were included 18 studies with the following interventions: creative arts, mind-body interventions, and body psychotherapy. Negative symptoms (total value), affective blunting, anhedonia, avolition, alogia, asociality, and psychomotor slowing were studied. In conclusion, there is strong scientific evidence that: body-oriented therapies do not promote positive effects on avolition, when it is assessed using the SANS scale; and creative arts reduce the total value of negative symptoms, when assessed by PANSS.
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Affiliation(s)
- Bruna Isabelinha
- Department of Sport and Health, School of Health and Human Development University of Évora, Colégio Luís António Verney Rua Romão Ramalho, 59 7000-671, Évora, Portugal.
| | - Ana Cruz-Ferreira
- Department of Sport and Health, School of Health and Human Development University of Évora, Colégio Luís António Verney Rua Romão Ramalho, 59 7000-671, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Universidade de Évora, Portugal.
| | - Janete Maximiano
- Department of Sport and Health, School of Health and Human Development University of Évora, Colégio Luís António Verney Rua Romão Ramalho, 59 7000-671, Évora, Portugal; Serviço Psiquiatria e Saúde Mental Adultos, Hospital Professor Doutor Fernando Fonseca, EPE, IC 19 - Venteira, 2720-276, Amadora, Portugal.
| | - Gabriela Almeida
- Department of Sport and Health, School of Health and Human Development University of Évora, Colégio Luís António Verney Rua Romão Ramalho, 59 7000-671, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Universidade de Évora, Portugal.
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Yip ALK, Karatzias T, Chien WT. Mindfulness-based interventions for non-affective psychosis: a comprehensive systematic review and meta-analysis. Ann Med 2022; 54:2340-2353. [PMID: 36004784 PMCID: PMC9423825 DOI: 10.1080/07853890.2022.2108551] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
AIM Although mindfulness-based interventions (MBIs) are routinely used in clinical practice, a comprehensive synthesis of the effectiveness of MBIs for non-affective psychosis has yet to be conducted. The aim of the present review and meta-analysis was to investigate the effectiveness of MBIs including those with mindfulness as an active treatment component for alleviating symptoms of psychosis to inform future clinical practice. METHODS A systematic review of studies published in journals or in dissertations in CINAHL, PubMed, EMBASE, PsycINFO, CENTRAL, ISRCTN, or CNKI from January 1990 until December 2020. A total of 31 eligible studies (n = 2146) were included. RESULTS Effect-size estimates suggested that 22 independent samples (n = 1632) produced a statistically significant small effect for psychotic symptoms (g = -0.48), and with a clinically significant reduction of 50% from baseline (pooled OR: 1.84). Separate meta-analyses demonstrated small effects for affective symptoms (g = -0.44) and small-to-large positive effects for quality of life (g = 0.38), mindfulness skills (g = 0.45), and insight into illness/treatment (g = 1.35). The heterogeneity was high across the studies. CONCLUSION Results suggest that short-term MBIs can be beneficial for non-affective psychosis. Future research is needed to test the efficacy and safety of dedicated MBIs for this population group over a longer term. KEY MESSAGESSchizophrenia spectrum and other psychotic disorders, also known as non-affective psychosis, is the most chronic and debilitating type of psychosis, seriously affecting every aspect of a person's life, including social, occupational, or general functioning.The aim of the current systematic review and meta-analysis was to investigate formerly unexamined questions regarding the clinical significance of MBIs including yoga as an increasingly utilized, conceptualized psychological intervention on overall psychotic symptoms for people with non-affective psychosis.No serious adverse events were reported in the studies, suggesting that MBIs may be safe interventions, while there is robust evidence to support the view that MBIs are beneficial to young people in particular.
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Affiliation(s)
- Annie Lai King Yip
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
| | - Wai Tong Chien
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK
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14
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Bhatia T, Kumari N, Yadav A, Beniwal RP, Shah G, Joel W, Jones JR, Iyenger S, Nimgaonkar VL, Deshpande SN. Feasibility, acceptability and evaluation of meditation to augment yoga practice among persons diagnosed with schizophrenia. Acta Neuropsychiatr 2022; 34:330-343. [PMID: 35586878 PMCID: PMC10174753 DOI: 10.1017/neu.2022.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To design a meditation protocol and test its feasibility, acceptability and efficacy in conjunction with yoga training (YT) for persons with schizophrenia (SZ). METHODS The meditation protocol consisted of Anapana (observing normal respiration) and Yoga Nidra (supine, restful awareness). In a single-blind randomised controlled trial, medicated and clinically stable outpatients diagnosed with SZ were randomised to receive treatment as usual (TAU), TAU augmented with YT or TAU augmented with meditation and yoga training (MYT) for 3 weeks (N = 145). Acceptability, clinical, social and cognitive functions were assessed after 3-week and 3-month post-randomisation using within-group and between-group analyses with repeated measures multivariate tests. RESULTS No group-wise differences in compliance, study discontinuation, major/serious side effects or adverse events were noted. For six assessed clinical variables, the direction of changes were in the desired direction and the effect sizes were greater in the MYT group compared with the TAU group at both time points. Changes in social function variables were greater at 3 months than at 3 weeks. Nominally significant improvement in individual cognitive domains were noted in all groups at both time points. All effect sizes were in the small to medium range. CONCLUSION MYT is feasible and acceptable and shows modest benefits for persons with SZ. MYT can also improve quality of life and clinical symptoms. Larger studies of longer duration are warranted.
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Affiliation(s)
- Triptish Bhatia
- Indo-US Projects, Department of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Nupur Kumari
- A multi-centric randomized controlled trial to evaluate the efficacy of telephone based psychological interventions on future suicide risk in suicide attempters, ICMR Project, Department of Psychiatry, Centre of Excellence in Mental Health, ABVIMS, Dr. Ram Manohar Lohia Hospital,New Delhi, India
| | - Ashok Yadav
- A pilot project to evaluate efficacy of yoga intervention for stress, anxiety and depression among healthcare professionals working in a frontline COVID-19 tertiary care hospital of New Delhi, Department of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS, Dr. Ram Manohar Lohia Hospital,New Delhi, India
| | - Ram Pratap Beniwal
- Department of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS, Dr. Ram Manohar Lohia Hospital,New Delhi, India
| | - Gyandeepak Shah
- National Coordination Unit-Indian Council of Medical Research, Dept. of Psychiatry and De-addiction, Centre of Excellence in Mental Health, ABVIMS, Dr. Ram Manohar Lohia Hospital,New Delhi, India
| | - Wood Joel
- Department of Psychiatry, WPIC, University of Pittsburgh, Pittsburgh, USA
| | - Jacquelynn R Jones
- Department of Psychiatry, WPIC, University of Pittsburgh, Pittsburgh, USA
| | - Satish Iyenger
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Vishwajit L Nimgaonkar
- Department of Psychiatry and Department of Human Genetics, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
- Behavioral Health Service line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Smita N Deshpande
- Department of Psychiatry, Centre of Excellence in Mental Health, Atal Bihari Vajpayee Institute of Medical Sciences-Dr. Ram Manohar Lohia Hospital, New Delhi, India
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15
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Piekorz Z, Radzimińska A, Lewandowski A, Ossowski R. Quality of Life in Yoga Practitioners-Research Conducted on a Population of Polish Yogis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12023. [PMID: 36231326 PMCID: PMC9566801 DOI: 10.3390/ijerph191912023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
Background: The aim of the study is to determine the quality of life of a population of healthy adult yoga practitioners and the correlation between the features of yoga practice and the quality of life. Methods: A total of 300 people aged 35-50 years were examined and divided into two groups. The respondent (SG; n = 150) was a yoga practitioner, and the control (CG; n = 150) did not practice yoga. The original questionnaire and the quality-of-life questionnaire (WHOQOL-BREF) were used. The chi-square test, the Kolmogorov-Smirnov test, the Mann-Whitney U test, the ANOVA Kruskal-Wallis test and the linear regression model were used. The significance level was set at p < 0.05. Results: Yoga practitioners are characterised by a significantly greater overall satisfaction with the quality of life (U = 9794.50; p < 0.05), a higher level of health satisfaction (U = 9194.50; p < 0.01) and higher satisfaction with quality life in terms of the results of somatic domains (U = 7579.00; p < 0.001), psychological (U = 8554.00; p < 0.001) and environmental domains (U = 7919.5; p < 0.001). A relationship was observed between the experience of yoga practice and the assessment of the quality of life in terms of physical functioning. Conclusions: The practice of adult yoga positively influences the assessment of their quality of life in the physical, mental and environmental spheres.
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Affiliation(s)
- Zuzanna Piekorz
- Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Agnieszka Radzimińska
- Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Andrzej Lewandowski
- Department of Physiotherapy, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Roman Ossowski
- Institute of Psychology, Kazimierz Wielki University in Bydgoszcz, 85-064 Bydgoszcz, Poland
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16
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O'Dea D, Curtis J, Scully A, Lappin J. A pilot study of a mindfulness informed yoga intervention in young people with psychosis. Early Interv Psychiatry 2022; 16:1036-1042. [PMID: 35106933 PMCID: PMC9545518 DOI: 10.1111/eip.13264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/28/2021] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
AIM To determine the acceptability and safety of a mindfulness informed yoga intervention as adjunct to usual care for young people with early psychosis. METHODS People aged 16-25 years attending a community-based specialist early psychosis clinic were invited to participate in a 12-week yoga intervention. The intervention consisted of 1-h weekly classes of mindfulness informed yoga. Acceptability was measured by uptake, attendance and participants' satisfaction. Safety was measured by incidence of physical injury, participants' level of comfort, distress and anxiety during the sessions, and the following mental health outcomes: positive and negative psychotic, depression, anxiety and stress symptoms, sleep quality and functioning. RESULTS Of those who consented to the study, 80% (12) participated and on average attended 4.4 yoga classes. There were no physical injuries and participants reported minimal distress and anxiety. Post-intervention, there was a significant reduction in anxiety symptoms and an improvement in function. CONCLUSIONS Mindfulness-based yoga interventions are both acceptable and safe as an intervention for youth with early psychosis. Though numbers were small, the study shows promise for yoga as a potentially useful intervention. Importantly, there was no deterioration in mental health outcomes. A larger trial evaluating clinical effectiveness is now timely.
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Affiliation(s)
- Destiny O'Dea
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Jackie Curtis
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia.,Early Psychosis Program, Bondi Junction Community Mental Health Centre, South Eastern Sydney Local Health District, New South Wales, Australia
| | - Alana Scully
- Early Psychosis Program, Bondi Junction Community Mental Health Centre, South Eastern Sydney Local Health District, New South Wales, Australia
| | - Julia Lappin
- Faculty of Medicine, University of New South Wales, Kensington, New South Wales, Australia.,Early Psychosis Program, Bondi Junction Community Mental Health Centre, South Eastern Sydney Local Health District, New South Wales, Australia
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17
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Sharma P, Yadav RK, Khadgawat R, Dada R. Transcriptional modulation of inflammation, and aging in Indian obese adults following a 12-week yoga-based lifestyle intervention: A randomized controlled trial. Front Med (Lausanne) 2022; 9:898293. [PMID: 36004368 PMCID: PMC9393383 DOI: 10.3389/fmed.2022.898293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Obesity is one of the major global problems in today's world, both in children, and the adult age group. Current evidence suggests obesity alters the expression of various genes related to oxidative stress, inflammation, and aging. In recent times complementary therapy like yoga-based lifestyle intervention (YBLI) is used as an adjunct therapy to modern medicine. This study examines the efficacy of 12 weeks of yoga-based lifestyle intervention with standard care (SC) on the expression of genes related to oxidative stress, inflammation, and aging in obese adults. Methods This was a two-arm parallel randomized control trial implemented at Integral Health Clinic (IHC), an outpatient facility that regularly conducted YBLI programs for the prevention of lifestyle diseases like obesity and diabetes in the Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi. Blood samples at baseline and weeks 2,4, and 12 were collected from 72 adults (male n = 21; female n = 51) of age 20-45 years with a body-mass index (BMI) of 25-35 kg/m2 who were randomized to receive either a 12-week SC (n = 36) or YBLI (n = 36). SC included recommendations for the management of obesity as per Indian guidelines including a low-calorie individualized diet and physical activity. Asana (physical postures), pranayama (breathing exercises), and meditation were all part of the YBLI. Primary outcomes were relative fold change in the expression of genes associated with oxidative stress [Nuclear factor-kappa B (NF-Kappa B)], inflammation [Tumor necrosis factor-α (TNFα), interleukin-6 (IL-6)], and aging [human telomerase reverse transcriptase (TERT)] in peripheral blood mononuclear cells between the two groups at week-12. Results There were no significant changes in fold change of TERT, IL-6, and NF-kappa B between the groups at week 12. The relative fold change of TERT was significantly greater in the YBLI group (p = <0.0001) vs the SC group at 2 weeks. The relative fold change of TNF α was significantly lower at week 12 in YBLI though the change was not continuous and reliable. Within both groups, TERT expression was significantly increased at week 2 though the change was greater in the YBLI group (p < 0.0001). TNF α gene expression was significantly lower at weeks 2 and 4, compared to baseline level, in the SC group but it increased at week 12. Conclusion The results while did not confirm our hypothesis, are important to share with the scientific society, to be able to improve prospective study designs and find optimal time/intervention/biological marker settings for this highly important scientific field. The results are suggestive of a positive impact of YBLI and SC on the fold change of aging-related TERT gene in obesity, though the benefit was not evident till week 12. However, the results should be evaluated with caution and in light of other published studies. To better understand the positive effects of YBLI on oxidative stress, inflammation, and aging-related gene expression in obesity, larger studies are recommended.
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Affiliation(s)
- Piyush Sharma
- Integral Health and Wellness Clinic, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Raj Kumar Yadav
- Integral Health and Wellness Clinic, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Khadgawat
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Rima Dada
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
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18
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Lavratti C, Iraci L, Ferreira A, Dorneles G, Pochmann D, da Rosa Boeira M, Peres A, Elsner V. Time course of epigenetic modulation in response to concurrent exercise training in patients with schizophrenia. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep210013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study aimed to investigate the short and long-term effects of concurrent exercise training on anthropometric variables, HDCA2 activity and cortisol levels of individuals with schizophrenia (SZ). Therefore, 10 patients were submitted to the program (endurance and strength exercises in the same session, 60 min of duration, three times a week) and blood samples were collected before, 30 days and 180 days after the intervention started. Exercise training reduced the body mass index and body mass after 180 days of the intervention. A significant decrease on HDAC2 activity was found 180 days after intervention compared to before the intervention. The cortisol levels remained unchanged in any evaluated time-points. The concurrent exercise training was able to modulate HDAC2 activity in mononuclear cells and improve anthropometric variables in a time-dependent manner in patients with SZ.
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Affiliation(s)
- C. Lavratti
- Programa de Pós Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, CEP 90420-060 Porto Alegre, RS, Brazil
| | - L. Iraci
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - A. Ferreira
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - G. Dorneles
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - D. Pochmann
- Programa de Pós Graduação em Biociências e Reabilitação doCentro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - M.C. da Rosa Boeira
- Programa de Pós Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, CEP 90420-060 Porto Alegre, RS, Brazil
| | - A. Peres
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - V.R. Elsner
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Biociências e Reabilitação doCentro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul, Brazil
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Physical Activity, Positive and Negative Symptoms of Psychosis, and General Psychopathology among People with Psychotic Disorders: A Meta-Analysis. J Clin Med 2022; 11:jcm11102719. [PMID: 35628845 PMCID: PMC9144999 DOI: 10.3390/jcm11102719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 02/05/2023] Open
Abstract
Objective: Existing reviews provided evidence for the associations between higher physical activity (PA) and lower negative symptoms of psychosis among people with schizophrenia. This meta-analysis goes beyond existing syntheses and investigates associations between PA, positive and negative symptoms of psychosis, as well as symptoms of general psychopathology (referring mostly to cognitive functioning) among people with schizophrenia, but also other psychotic disorders. The moderating roles of the type of diagnosis and the type of exercise intervention were explored. Methods: The study was registered with PROSPERO (CRD42018118236). Six electronic databases were searched; n = 27 experimental and observational studies were included, and psychotic symptoms-related data were recorded in one direction (higher values indicate better mental health and lower symptomatology). Results: Higher levels of PA (or participating in PA interventions) were associated with better mental health, that is, lower levels of positive symptoms (all studies: r = 0.170; experimental studies: SMD = 0.677), negative symptoms (all studies: r = 0.214; experimental studies: SMD = 0.838), and general psychopathology (all studies: r = 0.451; experimental studies: SMD = 1.511). The type of diagnosis (schizophrenia vs. other psychotic disorders) did not moderate these associations. Conclusions: We found a consistent pattern of associations between higher levels of PA and lower positive, negative, and general psychopathology symptoms in people with schizophrenia and those with other psychotic disorders.
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Nourollahimoghadam E, Gorji S, Gorji A, Khaleghi Ghadiri M. Therapeutic role of yoga in neuropsychological disorders. World J Psychiatry 2021; 11:754-773. [PMID: 34733640 PMCID: PMC8546763 DOI: 10.5498/wjp.v11.i10.754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.
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Affiliation(s)
| | - Shaghayegh Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
| | - Ali Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
- Department of Neuroscience, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran
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21
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Schulze T, Hahn E, Hahne I, Bergmann N, Fuchs LM, Mähler F, Zierhut MM, Ta TMT, Pijnenborg GHM, Böge K. Yoga-Based Group Intervention for In-patients With Schizophrenia Spectrum Disorders-A Qualitative Approach. Front Psychiatry 2021; 12:715670. [PMID: 34484004 PMCID: PMC8414901 DOI: 10.3389/fpsyt.2021.715670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Yoga may pose a promising complementary therapy in the multimodal treatment of in-patients with schizophrenia spectrum disorders (SSD). However, to date, no studies have qualitatively examined in-patients' with SSD experiences of Yoga as well as their perceptions of its limitations and benefits as a treatment component. This qualitative study aimed to explore for the first time the mechanisms and processes of Yoga-based Group Intervention (YoGI) for in-patients with SSD in Germany by asking for their subjective experiences. Findings could serve as a preliminary basis for developing an effective and evidence-based YoGI manual tailored to this patient group. Materials and Methods: In total, 25 semi-structured interviews were conducted directly after YoGI, for which responses were either noted down by hand or audio-recorded. The interview guide was pilot-tested and consisted of 14 questions to explore the personal articulated experiences of participation in YoGI from in-patients with SSD. Positive, negative, depressive, and anxiety symptoms were assessed during a diagnostic interview and through questionnaires. The interview data was transcribed, coded by two independent researchers, and analysed using an inductive thematic approach. The research team collaboratively discussed emerging categories to reduce redundancy and form meaningful themes and subthemes. Results: The analysis revealed seven main themes. YoGI was perceived as feasible and focusing on individual adaptation, captured by the theme inclusivity. Nevertheless, participants encountered challenges; thus, physical limitations need to be considered. While practising together, participants experienced interconnectedness and developed a mindful stance as they accepted their limitations and adapted exercises with self-compassion. Patients described that following the flow of the asanas required physical persistence, which ultimately led many participants to experience confidence and relaxation. YoGI affected symptom representation as heightened awareness led participants to notice impeding as well as improved symptoms. Conclusion: YoGI showed various promising effects on in-patients with SSD. Future research should examine to what extent these effects can be sustained and how the mindful approach during YoGI can be transferred to areas outside the Yoga class. Furthermore, a randomised controlled trial could investigate the effectiveness of a manualised YoGI.
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Affiliation(s)
- Theresa Schulze
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department Clinical Psychology and Experimental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Franziska Mähler
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marco Matthäus Zierhut
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gerdina Hendrika Maria Pijnenborg
- Department Clinical Psychology and Experimental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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22
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Rao NP, Ramachandran P, Jacob A, Joseph A, Thonse U, Nagendra B, Chako DM, Shiri S, Hassan H, Sreenivas V, Maran S, Durgam D, Nandakumar K, Varambally S, Gangadhar BN. Add on yoga treatment for negative symptoms of schizophrenia: A multi-centric, randomized controlled trial. Schizophr Res 2021; 231:90-97. [PMID: 33831770 DOI: 10.1016/j.schres.2021.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/28/2021] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Abstract
The efficacy of antipsychotic medications in the treatment of negative symptoms of schizophrenia is modest at best. Preliminary studies suggest the beneficial effects of add on Yoga, a traditional Indian practice, in the treatment of schizophrenia. Hence, in this study, we examined the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia in a randomized, wait-list controlled design from two clinical institutes in south India. 89 patients (age - 34.20 ± 8.06 years; education - 14.22 ± 2.69 years; 28 females) were randomized into the add-on yoga or treatment as usual (TAU - wait-list control) group. Patients had a mean illness duration of 10.97 ± 7.24 years with an age at onset of 23.34 ± 5.81 years. Central block randomization was followed to ensure concealed allocation. Participants randomized to the yoga treatment group attended 12 supervised yoga training sessions over two weeks and practiced yoga sessions at home for the subsequent 10 weeks. 64 patients completed the trial. An intent to treat analysis was conducted with 89 participants using a linear mixed model. Improvement in negative symptoms was our primary outcome measure. The two groups were matched on demographic variables and baseline psychopathology severity. Participants in the add-on yoga group had significantly greater improvement in negative symptoms (SANS baseline: 49.13 ± 2.30; 12-weeks follow up: 31.55 ± 2.53) compared to the TAU group (SANS baseline: 51.22 ± 2.40; 12-weeks follow up: 45.30 ± 2.93; t = 3.36; p = 0.006; Cohen's d-0.65). The current study findings suggest the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia. The effectiveness of yoga practice as a regular clinical intervention for patients needs to be explored in future studies by integrating yoga services along with other clinical services.
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Affiliation(s)
- Naren P Rao
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | | | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Albert Joseph
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Dona M Chako
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sahana Shiri
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Habla Hassan
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Sindhu Maran
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | | | | | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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23
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Dauwan M, Begemann MJH, Slot MIE, Lee EHM, Scheltens P, Sommer IEC. Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials. J Neurol 2021; 268:1222-1246. [PMID: 31414194 PMCID: PMC7990819 DOI: 10.1007/s00415-019-09493-9] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 01/20/2023]
Abstract
We performed a meta-analysis to synthesize evidence on the efficacy and safety of physical exercise as an add-on therapeutic intervention for quality of life (QoL), depressive symptoms and cognition across six chronic brain disorders: Alzheimer's disease, Huntington's disease, multiple sclerosis, Parkinson's disease, schizophrenia and unipolar depression. 122 studies ( = k) (n = 7231) were included. Exercise was superior to treatment as usual in improving QoL (k = 64, n = 4334, ES = 0.40, p < 0.0001), depressive symptoms (k = 60, n = 2909, ES = 0.78, p < 0.0001), the cognitive domains attention and working memory (k = 21, n = 1313, ES = 0.24, p < 0.009), executive functioning (k = 14, n = 977, ES = 0.15, p = 0.013), memory (k = 12, n = 994, ES = 0.12, p = 0.038) and psychomotor speed (k = 16, n = 896, ES = 0.23, p = 0.003). Meta-regression showed a dose-response effect for exercise time (min/week) on depressive symptoms (β = 0.007, p = 0.012). 69% of the studies that reported on safety, found no complications. Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders, with a positive dose-response correlation. Exercise also improved several cognitive domains with small but significant effects.
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Affiliation(s)
- Meenakshi Dauwan
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, VU University Medical Center Amsterdam, Neuroscience Campus, Postbus 7057, 1007 MB Amsterdam, The Netherlands
- Department of Biomedical Sciences of Cells and Systems Section, University of Groningen, University Medical Center Groningen, Neuroimaging Center 3111, Deusinglaan 2, 9713 AW Groningen, The Netherlands
| | - Marieke J. H. Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands
| | - Margot I. E. Slot
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands
| | - Edwin H. M. Lee
- Department of Psychiatry, 2/F, New Clinical Building, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands
| | - Iris E. C. Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Postbus 85500, 3508 GA Utrecht, The Netherlands
- Department of Biomedical Sciences of Cells and Systems Section, University of Groningen, University Medical Center Groningen, Neuroimaging Center 3111, Deusinglaan 2, 9713 AW Groningen, The Netherlands
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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24
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Fernández-Abascal B, Suárez-Pinilla P, Cobo-Corrales C, Crespo-Facorro B, Suárez-Pinilla M. In- and outpatient lifestyle interventions on diet and exercise and their effect on physical and psychological health: a systematic review and meta-analysis of randomised controlled trials in patients with schizophrenia spectrum disorders and first episode of psychosis. Neurosci Biobehav Rev 2021; 125:535-568. [PMID: 33503476 DOI: 10.1016/j.neubiorev.2021.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 12/22/2022]
Abstract
Patients with non-affective psychosis often lead unhealthy lifestyles. We performed a systematic review and meta-analysis on non-pharmacological RCTs for improvement of diet and physical activity in non-affective psychosis patients, including first-episode psychosis. A variety of outcomes was analysed, including metabolic, psychopathology, cognitive, functional and quality of life outcomes. Fifty-nine studies were included. An improvement in anthropometric measurements (BMI, weight, waist circumference) was observed post-intervention, persisting after follow-up. Post-intervention benefit was found also for psychotic symptoms severity (also persisting after follow-up), many cognitive domains and physical and global functioning and quality of life. Conversely, no effect was observed in relation to most blood metabolites, blood pressure and non-psychotic psychopathology and spontaneous physical activity. Improvement was generally larger for interventions including exercise, especially moderate/vigorous aerobic exercise, but follow-up maintenance was greater for psychotherapy interventions. Sensitivity analyses limited to chronic stages of psychosis and low risk of bias studies produced comparable results. Further studies are needed to design optimized interventions in this vulnerable population.
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Affiliation(s)
- Blanca Fernández-Abascal
- Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, 39011, Spain.
| | - Paula Suárez-Pinilla
- Department of Psychiatry, University Hospital Marqués de Valdecilla, IDIVAL, Santander, 39011, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain.
| | | | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocío - IBiS, Sevilla, 41013, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Marta Suárez-Pinilla
- Department of Neurodegenerative Disease, Institute of Neurology, University College of London, London, WC1N 3AX, UK.
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25
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Whybird G, Nott Z, Savage E, Korman N, Suetani S, Hielscher E, Vilic G, Tillston S, Patterson S, Chapman J. Promoting quality of life and recovery in adults with mental health issues using exercise and nutrition intervention. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1854023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Zoie Nott
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Emma Savage
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Nicole Korman
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Shuichi Suetani
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Emily Hielscher
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Gabrielle Vilic
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
| | - Stephen Tillston
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
| | - Sue Patterson
- Metro North Mental Health Service, Metro North Health, Brisbane, Queensland
| | - Justin Chapman
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland
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26
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Govindaraj R, Varambally S, Rao NP, Venkatasubramanian G, Gangadhar BN. Does Yoga Have a Role in Schizophrenia Management? Curr Psychiatry Rep 2020; 22:78. [PMID: 33141363 DOI: 10.1007/s11920-020-01199-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 01/28/2023]
Abstract
PURPOSE OF REVIEW To review the efficacy of add-on yoga therapy in improving symptoms of schizophrenia and quality of life and examine the possible underlying biological mechanisms of yoga in schizophrenia. RECENT FINDINGS Quality of life, cognitive symptoms, and negative symptoms have been found to improve with add-on yoga therapy in schizophrenia (pooled mean effect size 0.8, 0.6, and 0.4, respectively). Yoga also seems to have a small effect on improving positive symptoms. Less explored areas include adverse effects of yoga itself as well as its effects on antipsychotic-induced complications. Preliminary findings suggest that the effects of yoga may be mediated by neurohormonal mechanisms and functional changes in brain activity. Add-on yoga therapy is a potential treatment option for improving quality of life, cognitive symptoms, and negative symptoms in schizophrenia. Future studies should explore efficacy in multicentric trials as well as possible neurobiological changes underlying the effects.
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Affiliation(s)
- Ramajayam Govindaraj
- Centre for Consciousness Studies, Department of Neurophysiology, National Institute of Mental Health & Neurosciences, Bengaluru, India
| | - Shivarama Varambally
- Department of Integrative Medicine, National Institute of Mental Health & Neurosciences, Bengaluru, India. .,Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India.
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bengaluru, 560029, India
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27
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Wei GX, Yang L, Imm K, Loprinzi PD, Smith L, Zhang X, Yu Q. Effects of Mind-Body Exercises on Schizophrenia: A Systematic Review With Meta-Analysis. Front Psychiatry 2020; 11:819. [PMID: 32922321 PMCID: PMC7457019 DOI: 10.3389/fpsyt.2020.00819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Mind-body exercises (MBEs) have been widely accepted as a complementary therapy for the patients with low exercise tolerance. Currently, the number of experimental studies investigating the effect of MBEs for improving symptoms in people with schizophrenia is increasing. However, results are inconsistent. METHODS We systematically reviewed and meta-analyzed the effects of mind-body exercises on schizophrenia. Seven electronic databases (Pubmed, Web of Science, PsycINFO, Embase, Cochrane Central Register of Controlled Trials [CENTRAL], CNKI and Wangfang) were screened through October 2019 and risks of bias of included studies were assessed in Review Manager 5.3. RESULTS Meta-analysis on 13 studies with 1,159 patients showed moderately significant effects in favor of mind-body exercise intervention to improve positive symptoms (SMD = 0.31; 95% CI 0.01 to 0.60; p = 0.04), negative symptoms (SMD = 0.37; 95% CI 0.14 to 0.60; p = 0.002), and depression (SMD = 0.88; 95% CI 0.63 to 1.13; p<0.00001). Meta-regression analysis revealed that the improvement in positive symptoms was positively associated with the frequency of intervention (p = 0.04), while a marginally significant correlation was observed between the improved negative symptoms and duration of each session (p = 0.06). CONCLUSIONS This meta-analysis supports the therapeutic effects of MBEs to aid in the treatment of schizophrenia. Further studies need to incorporate rigorous design and large sample size to identify the optimal type and dose of mind-body exercise to inform clinical practices on MBEs' recommendations for the management of schizophrenia symptoms.
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Affiliation(s)
- Gao-Xia Wei
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kellie Imm
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Paul D. Loprinzi
- Department of Health, Exercise Science and Recreation Management School of Applied Sciences, The University of Mississippi, Oxford, MS, United States
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Qian Yu
- Center for Lifestyle and Mental Health, School of Psychology, Shenzhen University, Shenzhen, China
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
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28
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Brinsley J, Schuch F, Lederman O, Girard D, Smout M, Immink MA, Stubbs B, Firth J, Davison K, Rosenbaum S. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med 2020; 55:992-1000. [PMID: 32423912 DOI: 10.1136/bjsports-2019-101242] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess whether physically active yoga is superior to waitlist control, treatment as usual and attention control in alleviating depressive symptoms in people with a diagnosed mental disorder recognised by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DESIGN Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. DATA SOURCES Data were obtained from online databases (MEDLINE, EMBASE, PsychINFO, CENTRAL, EMCARE, PEDro). The search and collection of eligible studies was conducted up to 14 May 2019 (PROSPERO registration No CRD42018090441). ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomised controlled trials with a yoga intervention comprising ≥50% physical activity in adults with a recognised diagnosed mental disorder according to DSM-3, 4 or 5. RESULTS 19 studies were included in the review (1080 participants) and 13 studies were included in the meta-analysis (632 participants). Disorders of depression, post-traumatic stress, schizophrenia, anxiety, alcohol dependence and bipolar were included. Yoga showed greater reductions in depressive symptoms than waitlist, treatment as usual and attention control (standardised mean difference=0.41; 95% CI -0.65 to -0.17; p<0.001). Greater reductions in depressive symptoms were associated with higher frequency of yoga sessions per week (β=-0.44, p<0.01).
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Affiliation(s)
- Jacinta Brinsley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Oscar Lederman
- Keeping the Body In Mind, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Danielle Girard
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Matthew Smout
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, South Australia, Australia
| | - Maarten A Immink
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Kade Davison
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia: Allied Health and Human Performance, Adelaide, South Australia, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Black Dog Institute, Randwick, New South Wales, Australia
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29
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Lee K, Choi HS, Han M. Effects of therapeutic lifestyle change mentoring on cardio-metabolic factors for schizophrenia. Arch Psychiatr Nurs 2020; 34:19-26. [PMID: 32035584 DOI: 10.1016/j.apnu.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022]
Abstract
Considering that the prevalence of cardio-metabolic syndrome in patients with chronic schizophrenia is two or three times higher than the general population, this study aimed to provide patients with schizophrenia using community psychiatric rehabilitation services with therapeutic lifestyle change (TLC) mentoring using a smartphone application and provide inpatients in a psychiatric ward with structured TLC mentoring, to compare improvement in cardio-metabolic factors between the two groups. The home-based community service users using a TLC application were more likely to experience an improvement in their cardio-metabolic factors than the inpatients provided with the structured TLC program.
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Affiliation(s)
- Kyunghee Lee
- College of Nursing, Keimyung University, Daegu City, Republic of Korea.
| | | | - Mihwa Han
- Department of Nursing, Sunlin University, Pohang, Republic of Korea
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30
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Gautam S, Jain A, Marwale AV, Gautam A. Clinical Practice Guidelines for Yoga and Other Alternative Therapies for Patients with Mental Disorders. Indian J Psychiatry 2020; 62:S272-S279. [PMID: 32055069 PMCID: PMC7001345 DOI: 10.4103/psychiatry.indianjpsychiatry_776_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/01/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Shiv Gautam
- Gautam Hospital and Institute of Behavioural Sciences, Jaipur, Rajasthan, India
| | | | | | - Anita Gautam
- Gautam Hospital and Research Center, Jaipur, Rajasthan, India
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31
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Kaushik M, Jain A, Agarwal P, Joshi SD, Parvez S. Role of Yoga and Meditation as Complimentary Therapeutic Regime for Stress-Related Neuropsychiatric Disorders: Utilization of Brain Waves Activity as Novel Tool. J Evid Based Integr Med 2020; 25:2515690X20949451. [PMID: 32985243 PMCID: PMC7545749 DOI: 10.1177/2515690x20949451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 12/17/2022] Open
Abstract
During recent decades, stress-related neuropsychiatric disorders such as anxiety, depression, chronic tension headache, and migraine have established their stronghold in the lives of a vast number of people worldwide. In order to address this global phenomenon, intensive studies have been carried out leading to the advancement of drugs like anti-depressants, anxiolytics, and analgesics which although help in combating the symptoms of such disorders but also create long-term side effects. Thus, as an alternative to such clinical practices, various complementary therapies such as yoga and meditation have been proved to be effective in alleviating the causes and symptoms of different neuropsychiatric disorders. The role of altered brain waves in this context has been recognized and needs to be pursued at the highest level. Thus, the current study provides a review focused on describing the effects of yoga and meditation on anxiety and depression as well as exploring brain waves as a tool for assessing the potential of these complementary therapies for such disorders.
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Affiliation(s)
- Medha Kaushik
- Department of Toxicology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Akarshi Jain
- Department of Computer Science, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Puneet Agarwal
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Shiv Dutt Joshi
- Department of Electrical Engineering, Indian Institute of Technology, Hauz Khas, New Delhi, India
| | - Suhel Parvez
- Department of Toxicology, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
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32
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Abstract
Background:Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation.Methodology:We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’Results:A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use.Conclusion:There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.
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33
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Sabe M, Sentissi O, Kaiser S. Meditation-based mind-body therapies for negative symptoms of schizophrenia: Systematic review of randomized controlled trials and meta-analysis. Schizophr Res 2019; 212:15-25. [PMID: 31378557 DOI: 10.1016/j.schres.2019.07.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 02/01/2023]
Abstract
Meditation-based mind-body therapies (yoga, tai-chi, qi-gong, mindfulness) have been suggested to have a potential therapeutic effect on negative symptoms. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) examining effectiveness of yoga, tai-chi, qi-gong and mindfulness on negative symptoms of schizophrenia, using different databases and trial registries. The primary outcome was effect of mind-body therapies on negative symptoms and the secondary outcome was effect on positive symptoms. Fifteen RCTs were included in the meta-analysis (N = 1081 patients). Overall, we found a beneficial effect of mind-body interventions on negative symptoms at endpoint compared to treatment-as-usual or non-specific control interventions, but the effect was small and moderate to high heterogeneity was present. A subgroup analysis for different types of therapy revealed a significant effect of mindfulness-based and yoga interventions on negative symptoms, but heterogeneity within the yoga subgroup was high. Our results did not show an increase of positive symptoms (N = 1051). Our results suggest a potential for meditation-based mind-body therapies in the treatment of negative symptoms, in particular for mindfulness based approaches and to a lesser extent yoga. Limitations in the available comparisons do not allow concluding on a specific effect of these interventions. Overall, the currently available evidence remains limited and does not yet allow one to recommend mind-body therapies for the reduction of negative symptoms. However, the present findings justify further research on mind-body therapies for the treatment of negative symptoms.
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Affiliation(s)
- Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226 Thonex, Switzerland.
| | - Othman Sentissi
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226 Thonex, Switzerland.
| | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226 Thonex, Switzerland.
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Wang X, Beauchemin J, Liu C, Lee MY. Integrative Body-Mind-Spirit (I-BMS) Practices for Schizophrenia: An Outcome Literature Review on Randomized Controlled Trials. Community Ment Health J 2019; 55:1135-1146. [PMID: 31134445 DOI: 10.1007/s10597-019-00409-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 05/13/2019] [Indexed: 11/25/2022]
Abstract
Prior reviews show that certain complementary and alternative practices are promising for patients with schizophrenia. The aim of this study is to review the outcome literature on intervention studies using integrative body-mind-spirit (I-BMS) practices on schizophrenia. This is an outcome literature review of randomized controlled trials (RCTs) on I-BMS practices from 2004 to 2016. The review used a modified Delphi List to assess methodological rigor and the California Evidence-Based Clearinghouse Scientific Rating Scale to evaluate the level of research support for each identified I-BMS practice. This review identified 13 RCTs of I-BMS practices, including mindfulness interventions (5), yoga (3), tai-chi (2), and relaxation (3). I-BMS practices were effective with medium to large effect sizes for alleviating symptoms, decreasing anxiety and stress, improving insight and mindfulness, subjective well-being and social/occupational functioning, as well as decreasing the frequency and duration of re-hospitalization. This review expands the knowledge base of treatment effectiveness pertaining to patients with schizophrenia.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, The David B. Falk College of Sport and Human Dynamics at Syracuse University, 400 White Hall, Syracuse, NY, 13244, USA.
| | | | - Chang Liu
- College of Social Work, The Ohio State University, Columbus, USA
| | - Mo Yee Lee
- College of Social Work, The Ohio State University, Columbus, USA
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Kavak Budak F, Yilmaz E. The effect of yoga on clinical insight and medication adherence in patients with schizophrenia - A randomized controlled trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vogel JS, van der Gaag M, Slofstra C, Knegtering H, Bruins J, Castelein S. The effect of mind-body and aerobic exercise on negative symptoms in schizophrenia: A meta-analysis. Psychiatry Res 2019; 279:295-305. [PMID: 30879703 DOI: 10.1016/j.psychres.2019.03.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This meta-analysis aims to evaluate the effects of different types of physical exercise (PE) on negative symptoms in schizophrenia patients. Mind-body exercise (MBE), aerobic exercise (AE) and resistance training (RT) will be investigated. METHOD The Cochrane Library, Medline, Embase and PsycINFO were searched from their inception until April 26, 2018. Randomized controlled trials comparing PE with any control group in patients with schizophrenia were included when negative symptoms had been assessed. This meta-analysis was conducted according to the PRISMA guidelines. The methodological quality of the included studies was assessed with the Cochrane Risk of Bias assessment tool. Moderator, sensitivity, and meta regression analyses were conducted to explore causes of heterogeneity and impact of study quality. RESULTS We included 22 studies (N = 1249). The overall methodological quality was poor. The meta-analysis (random effects model) showed a medium significant effect in favor of any PE intervention (Hedges' g = 0.434, 95% CI = 0.196-0.671) versus any control condition. MBE and AE respectively showed a medium significant effect (Hedges' g = 0.461) and a small significant effect (Hedges' g = 0.341) versus any control condition. The effect of RT could not be examined. The overall heterogeneity was high (I2 = 76%) and could not be reduced with moderator or sensitivity analyses. CONCLUSION This meta-analysis demonstrated that PE could be a promising intervention in the treatment of negative symptoms. However, the quality of the included studies was low and heterogeneity was high, which makes it impossible to make a clear recommendation. Therefore, results should be interpreted with care.
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Affiliation(s)
- Jelle Sjoerd Vogel
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University Medical Center Groningen, Rob Giel Research Center, P.O. 30.0001, 9700 RB, Groningen, the Netherlands.
| | - Mark van der Gaag
- VU University Amsterdam, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BR, Amsterdam, the Netherlands; Amsterdam Public Mental Health research institute, Van der Boechorststraat 1, 1081 BR, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN, The Hague, the Netherlands
| | - Christien Slofstra
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, the Netherlands
| | - Henderikus Knegtering
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Neuroimaging Center, Antonius Deusinglaan 1, 9700 AD, Groningen, the Netherlands
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, the Netherlands; University Medical Center Groningen, Rob Giel Research Center, P.O. 30.0001, 9700 RB, Groningen, the Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG, Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University Medical Center Groningen, Rob Giel Research Center, P.O. 30.0001, 9700 RB, Groningen, the Netherlands
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Moritz S, Schmidt SJ, Lüdtke T, Braunschneider LE, Manske A, Schneider BC, Veckstenstedt R. Post-psychotic depression: Paranoia and the damage done. Schizophr Res 2019; 211:79-85. [PMID: 31331785 DOI: 10.1016/j.schres.2019.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/28/2019] [Accepted: 06/25/2019] [Indexed: 12/11/2022]
Abstract
To mitigate the often chronic course of schizophrenia and improve functional outcome, researchers are increasingly interested in prodromal states and psychological risk factors that may predict the outbreak of psychotic symptoms, but are also amenable to change. In recent years, depressive symptoms have been proposed as precursors of psychosis and some interventional studies indicate that the amelioration of depressive symptoms and depression-related thinking styles (e.g., worrying) improves positive symptoms, thereby "killing two birds with one stone". Yet, in a prior study, we were unable to find a strong specific predictive role of depression on paranoia over three years, which may have been due to the use of a nonclinical sample with minimal/mild symptom fluctuations. To address this further, in the present study we adopted a similar methodological approach but assessed a large patient sample with a schizophrenia spectrum disorder at three assessment points; baseline (N = 250), 6 weeks later (n = 207, 82.8% retention) and 6 months after baseline (n = 185, 74% retention). Using cross-lagged modeling, we assessed paranoia with the respective items from the Positive and Negative Syndrome Scale (PANSS) and the Psychosis Rating Scales (PSYRATS) delusions subscale. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9) and the Calgary Depression Scale for Schizophrenia (CDSS). We could identify a significant pathway from depression to paranoia from baseline to post (negative association) but not from post to follow-up. Paranoia significantly predicted depressive symptoms for both intervals. Our findings do not refute claims that depression may precede or even predict psychosis, but such a linkage does not seem to be ubiquitous.
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Affiliation(s)
- Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany.
| | - Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thies Lüdtke
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany; Department of Psychology, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Lea-Elena Braunschneider
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
| | - Alisa Manske
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Brooke C Schneider
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
| | - Ruth Veckstenstedt
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
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Bukar NK, Eberhardt LM, Davidson J. East meets west in psychiatry: Yoga as an adjunct therapy for management of anxiety. Arch Psychiatr Nurs 2019; 33:371-376. [PMID: 31280782 DOI: 10.1016/j.apnu.2019.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/18/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE Provide yoga for coping and symptom management in a locked, adult inpatient psychiatric unit. DESIGN Hatha yoga was offered to inpatients with mood disorders and/or psychosis 3 times per week in this evidence-based practice change project. Impact on sleep was examined using recorded sleep hours. Anxiety symptoms were assessed using 6 of the 7 symptoms recorded on the Generalized Anxiety Disorders (GAD) 7. Sustainability of benefits was examined. A self-assessment was conducted at discharge to determine acquisition of new coping skills. RESULTS No difference in sleep hours or interruptions was noted. A statistically significant increase in the total anxiety scores (z = -1.9815, p = 0.02385) and sustainability of benefits (z = -2.0894, p = 0.03662) between the first and second yoga class were observed. A positive change from baseline in sustainability of symptoms for "less anxiety" (k = 0.108) and "more relaxed" (k = 0.083) was found. There was a significant increase in utilization of yoga (p = 0.0015) and meditation (p = 0.013) as coping mechanisms at discharge. CONCLUSIONS Adults in an acute inpatient psychiatric unit who participated in yoga practice identified yoga and meditation as newly-acquired coping mechanisms and reported significant improvement in anxiety symptoms with sustained benefits ranging from half day to full day.
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Affiliation(s)
- Nadia K Bukar
- Senior Behavioral Health Intensive Outpatient Program (SBH IOP), UC San Diego Medical Center, 410 Dickinson Street, San Diego, CA 92103, United States of America.
| | - Luann M Eberhardt
- Neurobehavioral Medicine Unit (NBMU), UC San Diego Medical Center, 415 Dickinson Street, San Diego, CA 92103, United States of America.
| | - Judy Davidson
- Nursing Education, Development, and Research, UC San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, United States of America.
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Broderick J, Vancampfort D. Yoga as part of a package of care versus non-standard care for schizophrenia. Cochrane Database Syst Rev 2019; 4:CD012807. [PMID: 30990224 PMCID: PMC6466669 DOI: 10.1002/14651858.cd012807.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Yoga is an ancient body-mind practice which originated in India and is popular in the Western world as a form of relaxation and exercise. It has been of interest for people with schizophrenia to determine the efficacy of yoga delivered as a package of care versus non-standard care. OBJECTIVES To examine the effects of yoga as part of a package of care versus non-standard care for schizophrenia. SEARCH METHODS We searched the Cochrane Schizophrenia Group Trials Register (latest 15 May 2018) which is based on regular searches of MEDLINE, PubMed, Embase, CINAHL, BIOSS, AMED, PsychINFO, and registries of clinical trials. We searched the references of all included studies. There are no language, date, document type, or publication status limitations for inclusion of records in the register. SELECTION CRITERIA All randomised controlled trials (RCTs) including people with schizophrenia comparing yoga as part of a package of care with non-standard care. DATA COLLECTION AND ANALYSIS There were no data to analyse as no studies met the inclusion criteria. MAIN RESULTS The searches identified 30 studies that could be relevant to this review. After careful inspection, 29 were excluded and one is awaiting classification. No data were available for analyses. AUTHORS' CONCLUSIONS In view of the lack of evidence from RCTs, it is currently not possible for us to comment on the use of yoga as part of a package of care versus non-standard care.
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Affiliation(s)
- Julie Broderick
- Trinity Centre for Health SciencesDiscipline of PhysiotherapySt James's HospitalDublinIreland
| | - Davy Vancampfort
- Katholieke Universiteit LeuvenDepartment of Rehabilitation SciencesTervuursevest 101LeuvenBelgium3001
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Caponnetto P, Auditore R, Maglia M, Pipitone S, Inguscio L. Psychological wellness, yoga and quality of life in patients affected by schizophrenia spectrum disorders: A pilot study. Ment Illn 2019; 11:8003. [PMID: 31281606 PMCID: PMC6589643 DOI: 10.4081/mi.2019.8003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/20/2019] [Indexed: 12/04/2022] Open
Abstract
Schizophrenia is a serious psychiatric disorder characterized by positive symptoms, negative symptoms and neurocognitive deficits. The aim of this study was to estimate relationships between wellness, yoga and quality of life in patients affected by schizophrenia spectrum disorders. Participants were 30 patients with a diagnosis of schizophrenia in care at the Rehabilitative Psychiatry and Research Villa Chiara Clinic in Mascalucia (Catania, Italy), after that randomly assigned to two groups. The first group followed the experimental treatment with sets of yoga exercises conducted by a yoga trainer and a psychiatrist or a clinical psychologist expert in yoga, while a second control group was treated with usual care. The results revealed a significant difference, before and after treatment, between the experimental group and the control group in quality of life.
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Affiliation(s)
- Pasquale Caponnetto
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy.,Department of Clinical and Experimental Biomedicine, University of Catania, Italy.,Institute for Social Marketing, University of Stirling, UK
| | - Roberta Auditore
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy
| | - Marilena Maglia
- CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research, Mascalucia, Italy.,Department of Clinical and Experimental Biomedicine, University of Catania, Italy
| | - Stefano Pipitone
- Vidya Vahini Trust, Uttarkashi, Himalayas, India.,Yoga Vidya, Siracusa, Italy
| | - Lucio Inguscio
- Department of Psychology, La Sapienza University, Rome, Italy
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Sathyanarayanan G, Vengadavaradan A, Bharadwaj B. Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. Int J Yoga 2019; 12:3-28. [PMID: 30692780 PMCID: PMC6329226 DOI: 10.4103/ijoy.ijoy_65_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders. Aims: We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Methods: We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references. Results: We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD. Conclusion: Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.
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Affiliation(s)
- Gopinath Sathyanarayanan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ashvini Vengadavaradan
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Balaji Bharadwaj
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Sfendla A, Malmström P, Torstensson S, Kerekes N. Yoga Practice Reduces the Psychological Distress Levels of Prison Inmates. Front Psychiatry 2018; 9:407. [PMID: 30233428 PMCID: PMC6129942 DOI: 10.3389/fpsyt.2018.00407] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/10/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Psychiatric ill-health is prevalent among prison inmates and often hampers their rehabilitation. Rehabilitation is crucial for reducing recidivistic offending. A few studies have presented evidence of the positive effect of yoga on the well-being of prison inmates. The conclusion of those previous studies that yoga is an effective method in the rehabilitation process of inmates, and deserves and requires further attention. Aims: The current study aimed to evaluate the effect of 10 weeks of yoga practice on the mental health profile, operationalized in the form of psychological distress, of inmates. Methods: One hundred and fifty-two volunteer participants (133 men; 19 women) were randomly placed in either of two groups: to participate in weekly 90-min yoga class (yoga group) or a weekly 90-min free-choice physical exercise (control group). The study period lasted for 10 weeks. Prior to and at the end of the study period the participants completed a battery of self-reported inventories, including the Brief Symptom Inventory (BSI). Results: Physical activity (including yoga) significantly reduced the inmates' levels of psychological distress. Yoga practice improved all primary symptom dimensions and its positive effect on the obsessive-compulsive, paranoid ideation, and somatization symptom dimensions of the BSI stayed significant even when comparing with the control group. Conclusions: Yoga as a form of physical activity is effective for reducing psychological distress levels in prison inmates, with specific effect on symptoms such as suspicious and fearful thoughts about losing autonomy, memory problems, difficulty in making decisions, trouble concentrating, obsessive thought, and perception of bodily dysfunction.
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Affiliation(s)
- Anis Sfendla
- Department of Biology, Faculty of Sciences, Abdelmalek Essaâdi University, Tetouan, Morocco
| | - Petter Malmström
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Sara Torstensson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
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Tréhout M, Dollfus S. [Physical activity in patients with schizophrenia: From neurobiology to clinical benefits]. Encephale 2018; 44:538-547. [PMID: 29983176 DOI: 10.1016/j.encep.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/17/2018] [Accepted: 05/18/2018] [Indexed: 01/21/2023]
Abstract
Schizophrenia is a severe chronic mental disorder that mainly manifests by positive symptoms, negative symptoms, disorganized behavior and thought and cognitive impairments. Taken together, these symptoms have substantial impact on quality of life, well-being and functional outcome. Patients with schizophrenia have dramatically higher levels of cardiovascular and metabolic morbidity than the general population due to poor physical fitness and to sedentary lifestyle. They have a reduced life expectancy, and an excess mortality being two or three times more than that in the general population. Moreover, despite major therapeutic advances in the overall management of these patients, some symptomatic dimensions, and more specifically the negative and cognitive ones, remain to be resistant to the usual pharmacological approaches. Moreover, antipsychotics can also reinforce the global cardiovascular risk due to side effects and low neurometabolic tolerance. The benefits of physical activity on health are now well described in the general population and in many medical diseases. More recently, physical activity has also found its place as an adjuvant therapy in severe mental illnesses, particularly in schizophrenia. In the literature physical activity programs, in addition to pharmacological treatments, appear to be feasible in patients and improve both physical and mental health as well as functional outcome. Clinical benefits of physical activity would be underpinned by biological and cerebral mechanisms, which remain unclear. In this review, we propose to present a state of the art and to present an update of the interests of physical activity in the management of patients with schizophrenia. We emphasize the clinical benefits of physical activity regarding the different symptomatic dimensions and its impact specifically on cognitive deficits. Finally, we describe the various underlying pathophysiological mechanisms in particular in the neurobiological, cerebral and physiological fields. We then discuss the barriers, facilitators and motivating factors towards physical activity to enhance health promotion initiatives, to optimize resource allocation when delivering physical activity programs in clinical practice, and to maximize physical activity participation. Physical activity appears to be an original and novel adjunctive therapeutic approach in the management of patients with schizophrenia and would both reduce schizophrenic symptoms and act like pro-cognitive therapy, improve quality of life and long-term functioning in daily life and reduce cardiovascular comorbidities. However, efforts are still needed to increase the motivating factors and adherence towards physical activity participation for people with schizophrenia.
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Affiliation(s)
- M Tréhout
- Service de psychiatrie, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; UFR de médecine, UNICAEN, Normandie université, 14000 Caen, France; ISTS, UNICAEN, Normandie université, 14000 Caen, France.
| | - S Dollfus
- Service de psychiatrie, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; UFR de médecine, UNICAEN, Normandie université, 14000 Caen, France; ISTS, UNICAEN, Normandie université, 14000 Caen, France
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Verma M, Bhargav H, Varambally S, Raghuram N, Bn G. Effect of integrated yoga on anti-psychotic induced side effects and cognitive functions in patients suffering from schizophrenia. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2018; 16:jcim-2017-0155. [PMID: 29944467 DOI: 10.1515/jcim-2017-0155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/02/2018] [Indexed: 12/17/2022]
Abstract
Background Twenty one (12 females) subjects, diagnosed with schizophrenia by a psychiatrist using ICD-10, in the ages 52.87 + 9.5 years and suffering since 24.0 ± 3.05 years were recruited into the study from a schizophrenia rehabilitation center in Bengaluru. Methods All subjects were taking anti-psychotic medications and were in stable state for more than a month. Psychiatric medications were kept constant during the study period. Assessments were done at three points of time: (1) baseline, (2) after one month of usual routine (pre) and (3) after five months of validated Integrated Yoga (IY) intervention (post). Validated 1 h Yoga module (consisting of asanas, pranayama, relaxation techniques and chantings) was practiced for 5 months, five sessions per week. Antipsychotic-induced side effects were assessed using Simpson Angus Scale (SAS) and Udvalg for Kliniske Undersogelser (UKU) side effect rating scale. Cognitive functions (using Trail making Test A and B), clinical symptoms and anthropometry were assessed as secondary variables. Comparisons between "pre" and "post" data was done using paired samples t-tests after subtracting baseline scores from them respectively. Results At the end of five months, significant reduction in drug-induced Parkinsonian symptoms (SAS score; p=0.001) and 38 items of UKU scale was observed along with significant improvement in processing speed, executive functions and negative symptoms of schizophrenia patients. No side effects of Yoga were reported. Conclusions The present study provides preliminary evidence for usefulness of Integrated Yoga intervention in managing anti-psychotic-induced side effects.
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Affiliation(s)
- Meghnath Verma
- School of Yoga and Life Sciences, S-VYASA Yoga University, No.19, EknathBhavan, Gavipuram circle, Kempegowda Nagar, Bangalore560019, Karnataka, India
| | - Hemant Bhargav
- NIMHANS, Integrate Centre for Yoga, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru560029, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru560029, Karnataka, India
| | - Nagarathna Raghuram
- School of Yoga and Life Sciences, S-VYASA Yoga University, No.19, EknathBhavan, Gavipuram circle, Kempegowda Nagar, Bangalore560019, Karnataka, India
| | - Gangadhar Bn
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru560029, Karnataka, India
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Shortway KM, Prajapati S, Donald B, St Onge S. A preliminary investigation of the effects of one yoga session for service recipients in a behavioral health intensive outpatient program. Complement Ther Clin Pract 2018; 31:91-95. [PMID: 29705487 DOI: 10.1016/j.ctcp.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 01/06/2018] [Accepted: 02/01/2018] [Indexed: 10/18/2022]
Abstract
This was an investigation of the feasibility and effectiveness of a brief yoga intervention (one session) within an intensive outpatient program (IOP) for service recipients diagnosed with various psychiatric disorders. Participants (N = 26) completed the Toronto Mindfulness Scale (TMS) and the Positive and Negative Affect Schedule (PANAS). Data was collected before and after one yoga session and follow-up data was collected via mail after discharge from the IOP. Scores indicated that negative affect significantly decreased and positive affect significantly increased from pre to post yoga session. Mindfulness scores significantly increased from pre to post yoga session. Though the results of this study supported that a yoga intervention is both feasible and effective within an IOP, collection of follow-up data after discharge via mail was not as feasible. The results of this preliminary investigation support a larger and longitudinal study to further examine yoga as a treatment modality with this clinical population.
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Supriya R, Yu AP, Lee PH, Lai CW, Cheng KK, Yau SY, Chan LW, Yung BY, Siu PM. Yoga training modulates adipokines in adults with high-normal blood pressure and metabolic syndrome. Scand J Med Sci Sports 2018; 28:1130-1138. [PMID: 29205515 DOI: 10.1111/sms.13029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 01/04/2023]
Abstract
Metabolic syndrome (MetS) is associated with diabetes mellitus and cardiovascular diseases. Our previous study indicated that people with MetS showed a decrease in waist circumference and a decreasing trend in blood pressure after 1-year yoga. This study investigated the effect of yoga on MetS people with high-normal blood pressure by exploring modulations in proinflammatory adipokines (leptin, chemerin, visfatin, and plasminogen activator inhibitor-1 or PAI-1) and an anti-inflammatory adipokine (adiponectin). A total of 97 Hong Kong Chinese individuals aged 57.6 ± 9.1 years with MetS and high-normal blood pressure were randomly assigned to control (n = 45) and yoga groups (n = 52). Participants in the control group were not given any intervention but were contacted monthly to monitor their health status. Participants in the yoga group underwent a yoga training program with three 1-hour yoga sessions weekly for 1 year. The participants' sera were harvested and assessed for adipokines. Generalized estimating equation (GEE) was used to examine the interaction effect between 1-year time (pre vs post), and intervention (control vs yoga). GEE analyses revealed significant interaction effects between 1-year time and yoga intervention for the decreases in leptin and chemerin and the increase in adiponectin concentration in the sera examined. These results demonstrated that 1-year yoga training decreased proinflammatory adipokines and increased anti-inflammatory adipokine in adults with MetS and high-normal blood pressure. These findings support the beneficial role of yoga in managing MetS by favorably modulating adipokines.
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Affiliation(s)
- Rashmi Supriya
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Angus P Yu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul H Lee
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Christopher W Lai
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Kenneth K Cheng
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Sonata Y Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Lawrence W Chan
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Benjamin Y Yung
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Parco M Siu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
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Ikai S, Uchida H, Mizuno Y, Tani H, Nagaoka M, Tsunoda K, Mimura M, Suzuki T. Effects of chair yoga therapy on physical fitness in patients with psychiatric disorders: A 12-week single-blind randomized controlled trial. J Psychiatr Res 2017; 94:194-201. [PMID: 28750232 DOI: 10.1016/j.jpsychires.2017.07.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. METHODS In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual. Chair yoga therapy was conducted as twice-weekly 20-min sessions over 12 weeks. Assessments included anteflexion in sitting, degree of muscle strength, and Modified Falls Efficacy Scale (MFES) as well as QOL, psychopathology and functioning. RESULTS Fifty-six inpatients participated in this study (36 men; mean ± SD age, 55.3 ± 13.7 years; schizophrenia 87.5%). In the chair yoga group, significant improvements were observed in flexibility, hand-grip, lower limb muscle endurance, and MFES at week 12 (mean ± SD: 55.1 ± 16.6 to 67.2 ± 14.0 cm, 23.6 ± 10.6 to 26.8 ± 9.7 kg, 4.9 ± 4.0 to 7.0 ± 3.9 kg, and 114.9 ± 29.2 to 134.1 ± 11.6, respectively). Additionally, these improvements were observable six weeks after the intervention was over. The QOL-VAS improved in the intervention group while no differences were noted in psychopathology and functioning between the groups. The intervention appeared to be highly tolerable without any notable adverse effects. CONCLUSIONS The results indicated sustainable effects of 20-min, 12-week, 24-session chair yoga therapy on physical fitness. Chair yoga therapy may contribute to reduce the risk of falls and their unwanted consequences in psychiatric patients.
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Affiliation(s)
- Saeko Ikai
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan.
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan; Geriatric Mental Health Program, Centre for Addiction and Mental Health, 1001 Queen St W, Toronto, ON, M6J 1H4, Canada
| | - Yuya Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Hideaki Tani
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan
| | - Maki Nagaoka
- Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan; Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Kenichi Tsunoda
- Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Department of Psychiatry, Minami-Hanno Hospital, 415 Yaoroshi, Hanno-shi, Saitama, 357-0042, Japan; Department of Psychiatry, Inokashira Hospital, 4-14-1 Kamirenjaku, Mitaka, Tokyo, 181-0012, Japan
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Abstract
BACKGROUND Yoga is an ancient spiritual practice that originated in India and is currently accepted in the Western world as a form of relaxation and exercise. It has been of interest for people with schizophrenia to determine the efficacy of yoga delivered as a package of care versus standard care. OBJECTIVES To examine the effects of yoga as a package of care versus standard care. SEARCH METHODS We searched the Cochrane Schizophrenia Group Trials Register (latest 30 March 2017) which is based on regular searches of MEDLINE, PubMed, Embase, CINAHL, BIOSS, AMED, PsychINFO, and registries of clinical trials. We searched the references of all included studies. There are no language, date, document type, or publication status limitations for inclusion of records in the register. SELECTION CRITERIA All randomised controlled trials (RCTs) including people with schizophrenia comparing yoga as a package of care with standard-care control. DATA COLLECTION AND ANALYSIS The review authors independently selected studies, quality rated these, and extracted data. For binary outcomes, we calculated risk difference (RD) and its 95% confidence interval (CI), on an intention-to-treat (ITT) basis. For continuous data, we estimated the mean difference (MD) between groups and its CI. We employed mixed-effect and fixed-effect models for analysis. We examined heterogeneity (I2 technique), assessed risk of bias for included studies, and created a 'Summary of findings' table using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS Three studies are included in this review. All outcomes were short term (less than eight weeks). Useable data were reported for two outcomes only; leaving the study early and quality of life. None of the participants left the studies early and there was some evidence in favour of the yoga package for quality of life endpoint scores (1 RCT, n=80, MD 22.93 CI 19.74 to 26.12, low-quality evidence). Leaving the study early data were equivocal between the treatment groups (3 RCTs, n=193, RD 0.06 CI -0.01 to 0.13, medium-quality evidence, high heterogeneity). Overall, this review has an inordinate number of missing key outcomes, which included mental and global state, social functioning, physical health, adverse effects and costs of care. AUTHORS' CONCLUSIONS A small number of small studies were included in this review and these lacked many key outcomes. The sparse data means we cannot state with any degree of certainty if yoga delivered as a package of care is beneficial in comparison to standard care.
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Affiliation(s)
- Julie Broderick
- Trinity Centre for Health SciencesDiscipline of PhysiotherapySt James's HospitalDublinIreland
| | - Davy Vancampfort
- Katholieke Universiteit LeuvenDepartment of Rehabilitation SciencesTervuursevest 101LeuvenBelgium3001
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Abstract
BACKGROUND Yoga is an ancient spiritual practice that originated in India and is currently accepted in the Western world as a form of relaxation and exercise. It has been of interest for people with schizophrenia as an alternative or adjunctive treatment. OBJECTIVES To systematically assess the effects of yoga versus non-standard care for people with schizophrenia. SEARCH METHODS The Information Specialist of the Cochrane Schizophrenia Group searched their specialised Trials Register (latest 30 March 2017), which is based on regular searches of MEDLINE, PubMed, Embase, CINAHL, BIOSIS, AMED, PsycINFO, and registries of clinical trials. We searched the references of all included studies. There are no language, date, document type, or publication status limitations for inclusion of records in the register. SELECTION CRITERIA All randomised controlled trials (RCTs) including people with schizophrenia and comparing yoga with non-standard care. We included trials that met our selection criteria and reported useable data. DATA COLLECTION AND ANALYSIS The review team independently selected studies, assessed quality, and extracted data. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect models for analyses. We examined data for heterogeneity (I2 technique), assessed risk of bias for included studies, and created a 'Summary of findings' table for seven main outcomes of interest using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS We were able to include six studies (586 participants). Non-standard care consisted solely of another type of exercise programme. All outcomes were short term (less than six months). There was a clear difference in the outcome leaving the study early (6 RCTs, n=586, RR 0.64 CI 0.49 to 0.83, medium quality evidence) in favour of the yoga group. There were no clear differences between groups for the remaining outcomes. These included mental state (improvement in Positive and Negative Syndrome Scale, 1 RCT, n=84, RR 0.81 CI 0.62 to 1.07, low quality evidence), social functioning (improvement in Social Occupational Functioning Scale, 1 RCT, n=84, RR 0.90 CI 0.78 to 1.04, low quality evidence), quality of life (mental health) (average change 36-Item Short Form Survey (SF-36) quality-of-life sub-scale, 1 RCT, n=69, MD -5.30 CI -17.78 to 7.18, low quality evidence), physical health, (average change WHOQOL-BREF physical-health sub-scale, 1 RCT, n=69, MD 9.22 CI -0.42 to 18.86, low quality evidence). Only one study reported adverse effects, finding no incidence of adverse events in either treatment group. There were a considerable number of missing outcomes, which included relapse, change in cognition, costs of care, effect on standard care, service intervention, disability, and activities of daily living. AUTHORS' CONCLUSIONS We found minimal differences between yoga and non-standard care, the latter consisting of another exercise comparator, which could be broadly considered aerobic exercise. Outcomes were largely based on single studies with limited sample sizes and short-term follow-up. Overall, many outcomes were not reported and evidence presented in this review is of low to moderate quality - too weak to indicate that yoga is superior or inferior to non-standard care control for management of people with schizophrenia.
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Affiliation(s)
- Julie Broderick
- Trinity Centre for Health SciencesDiscipline of PhysiotherapySt James's HospitalDublinIreland
| | - Niall Crumlish
- St. James HospitalDepartment of PsychiatryJames StreetDublinIreland
| | - Alice Waugh
- St James HospitalDepartment of PhysiotherapyJames StreetDublinIreland
| | - Davy Vancampfort
- Katholieke Universiteit LeuvenDepartment of Rehabilitation SciencesTervuursevest 101LeuvenBelgium3001
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Tarpada SP, Morris MT. Physical Activity Diminishes Symptomatic Decline in Chronic Schizophrenia: A Systematic Review. PSYCHOPHARMACOLOGY BULLETIN 2017; 47:29-40. [PMID: 28936008 PMCID: PMC5601086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Physical activity has been shown to positively influence a number of parameters in chronic schizophrenia, including cognition, social well being, and quality of life. Here, we present a systematic review of randomized controlled trials reporting on reduction of positive and negative symptoms using PANSS grading after the implementation of a physical activity protocol. Review of 64 articles yielded 6 relevant to our discussion. We found that physical activity significantly improved aggregate total PANSS score as well as positive symptoms PANSS score. While negative PANSS score showe a trend toward improvement, this was nonsignificant. Overall, we find the various forms of physical activity discussed within to be an appropriate adjunct to standard pharmacotherapy for the reduction of symptoms in chronic schizophrenia.
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Affiliation(s)
- Sandip P Tarpada
- Mr. Tarpada, BA, and Morris, BA, Albert Einstein College of Medicine, Bronx, NY USA
| | - Matthew T Morris
- Mr. Tarpada, BA, and Morris, BA, Albert Einstein College of Medicine, Bronx, NY USA
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