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Yoga as an Integrative Therapy for Mental Health Concerns: An Overview of Current Research Evidence. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2040030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Because the prevalence of mental health concerns is high and access or full responsiveness to pharmacological or psychotherapeutic treatment for many individuals is low, there has been increased interest in yoga as a potential therapy for many mental health concerns. Approach: We synthesize and critique current research on the efficacy of yoga relative to pharmacological approaches for anxiety disorders, mood disorders, posttraumatic stress disorder, obsessive-compulsive disorder, and eating disorders. Results: Yoga has been tested mostly as a complementary treatment to standard psychiatric and psychotherapeutic approaches. Findings from efficacy trials largely support the notion that yoga can help reduce symptoms of many psychiatric conditions, including anxiety, depression, and PTSD symptoms, above and beyond the effects achieved by standard pharmacological treatments alone; however, most evidence is of poor to moderate quality. Plausible transdiagnostic bottom-up and top-down mechanisms of yoga’s therapeutic effects have been advanced but remain untested. Conclusions: While results should be considered preliminary until more rigorous evidence is available, yoga appears to have the potential to provide many people suffering with psychiatric symptoms additional relief at relatively little cost. Yoga may be a viable complementary therapy to psychiatric and psychotherapeutic approaches for people with mental health challenges.
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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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Kerekes N. Yoga as Complementary Care for Young People Placed in Juvenile Institutions-A Study Plan. Front Psychiatry 2021; 12:575147. [PMID: 34149466 PMCID: PMC8211756 DOI: 10.3389/fpsyt.2021.575147] [Citation(s) in RCA: 3] [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: 06/22/2020] [Accepted: 05/11/2021] [Indexed: 01/01/2023] Open
Abstract
Recent studies have established yoga practice as a mainstream complementary clinical tool within correctional environments. It is shown that regular yoga practice is coupled with improved impulse control, sustained attention, attenuated antisocial and self-harm behaviors, reduced stress, and psychological distress. No academic research until now has provided evidence of mental health benefits of yoga for institutionalized young people. In Sweden, each year more than thousand adolescents receive compulsory care at juvenile institutions run by the Swedish National Board of Institutional Care. These young people are characterized by substance abuse, aggressive and antisocial behaviors, high frequency of self-harm, and the experience of abuse. Most of them manifest attention problems, depression, anxiety, and impulsivity. They have a dramatically increased risk for recidivistic criminal behavior, continuous medical, and social care and untimely death. The present study plan aims at evaluating, with previously validated psychological measures, in a quasi-experimental design, the effects of yoga practice for institutionalized adolescents. Adolescents' experiences of participating in yoga practice will also be assessed by semi-structured individual interviews. Ethical approval was given by the Swedish Ethical Review Authority. It is hypothesized that yoga practice (in combination with the standard treatment within institutional care) will reduce institutionalized adolescents' aggression, antisocial behavior, anxiety, depression, and negative affect, and increase their cognitive flexibility (in the form of increased impulse control).
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Affiliation(s)
- Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan, Sweden
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Ashdown-Franks G, Firth J, Carney R, Carvalho AF, Hallgren M, Koyanagi A, Rosenbaum S, Schuch FB, Smith L, Solmi M, Vancampfort D, Stubbs B. Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes. Sports Med 2020; 50:151-170. [PMID: 31541410 DOI: 10.1007/s40279-019-01187-6] [Citation(s) in RCA: 186] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Exercise may improve neuropsychiatric and cognitive symptoms in people with mental disorders, but the totality of the evidence is unclear. We conducted a meta-review of exercise in (1) serious mental illness (schizophrenia spectrum, bipolar disorder and major depression (MDD)); (2) anxiety and stress disorders; (3) alcohol and substance use disorders; (4) eating disorders (anorexia nervosa bulimia nervosa, binge eating disorders, and (5) other mental disorders (including ADHD, pre/post-natal depression). METHODS Systematic searches of major databases from inception until 1/10/2018 were undertaken to identify meta-analyses of randomised controlled trials (RCTs) of exercise in people with clinically diagnosed mental disorders. In the absence of available meta-analyses for a mental disorder, we identified systematic reviews of exercise interventions in people with elevated mental health symptoms that included non-RCTs. Meta-analysis quality was assessed with the AMSTAR/+. RESULTS Overall, we identified 27 systematic reviews (including 16 meta-analyses representing 152 RCTs). Among those with MDD, we found consistent evidence (meta-analyses = 8) that exercise reduced depression in children, adults and older adults. Evidence also indicates that exercise was more effective than control conditions in reducing anxiety symptoms (meta-analyses = 3), and as an adjunctive treatment for reducing positive and negative symptoms of schizophrenia (meta-analyses = 2). Regarding neurocognitive effects, exercise improved global cognition in schizophrenia (meta-analyses = 1), children with ADHD (meta-analyses = 1), but not in MDD (meta-analyses = 1). Among those with elevated symptoms, positive mental health benefits were observed for exercise in people with pre/post-natal depression, anorexia nervosa/bulimia nervosa, binge eating disorder, post-traumatic stress disorder and alcohol use disorders/substance use disorders. Adverse events were sparsely reported. CONCLUSION Our panoramic meta-overview suggests that exercise can be an effective adjunctive treatment for improving symptoms across a broad range of mental disorders.
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Affiliation(s)
- Garcia Ashdown-Franks
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.,Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Rebekah Carney
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Mats Hallgren
- Unit of Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCS), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
| | - Simon Rosenbaum
- School of Psychiatry UNSW, Sydney, Australia.,Black Dog Institute, Sydney, Australia
| | - Felipe B Schuch
- Department of Methods and Sports Techniques, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Marco Solmi
- Neurosciences Department, University of Padova, Padua, Italy
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Louvain, Belgium.,UPC KU Leuven, Leuven-Kortenberg, Belgium
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK. .,Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK. .,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.
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Abstract
PURPOSE OF REVIEW Behavioral intervention describes multiple modalities of treatments which are of increasing interest in epilepsy. This review addresses recent behavioral clinical trials in epilepsy including cognitive behavioral therapy (CBT), mindfulness, progressive muscle relaxation (PMR), and self-management. Results and conclusions from updated Cochrane reviews and the recent International League Against Epilepsy Psychology task force are presented. RECENT FINDINGS Two recent large randomized controlled trials (mindfulness and progressive muscle relaxation) reported improved seizure frequency with behavioral treatments. In both studies, participants in both the active and the attentional control arms showed significant seizure reduction, whereas quality of life and stress reduction were better noted in the active arms. Additional behavioral modalities have reported improved seizure control including yoga, bio/neurofeedback, and music therapy.Significant improvements in multiple quality of life, cognitive domains, and medication adherence have been reported from randomized and open label trials of cognitive behavioral therapy, and self-management programs. Multiple promising self-management programs have been recently reported, often utilizing the power of web-based apps, and digitally delivered group therapy. In 2018, the International League Against Epilepsy Psychology task force recommended that 'psychological interventions should be incorporated into comprehensive epilepsy care.' SUMMARY Behavioral treatments are successful and likely underutilized in the treatment of epilepsy. Given the challenge of conducting randomized clinical trials of behavioral therapy, much remains to be studied. However, for motivated and interested patients, appropriately chosen behavioral therapies appear to be important adjuncts to standard therapy. The timing is currently optimal to take best advantage of smartphone apps and web-based delivery systems, both for research and therapeutic purposes.
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Affiliation(s)
- Sheryl R Haut
- Montefiore-Einstein Epilepsy Center.,Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan M Gursky
- Montefiore-Einstein Epilepsy Center.,Department of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Michael Privitera
- Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Abstract
BACKGROUND Evidence suggests that yoga may be an effective treatment for major depressive disorder (MDD). Studies evaluating the "dosing" of yoga treatment and efficacy for MDD are needed. The goal of this study was to assess the effects of an intervention combining Iyengar yoga and coherent breathing in participants with MDD and determine the optimal intervention dose. METHODS Thirty-two participants (18 to 65 y of age) diagnosed with MDD were randomized to a high-dose group (HDG) or a low-dose group (LDG) of yoga and coherent breathing for 12 weeks. The HDG (n=15) involved three 90-minute yoga classes and four 30-minute homework sessions per week. The LDG (n=15) involved two 90-minute yoga classes and three 30-minute homework sessions per week. Participants were evaluated at baseline, week 4, week 8, and week 12 with the following instruments: Positivity Self-Test, Spielberger State Anxiety Inventory, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, and Exercise-induced Feeling Inventory. Data were analyzed using intent-to-treat methods. RESULTS Significant improvements in all outcome measures were found for both groups, with acute and cumulative benefits. Although the HDG showed greater improvements on all scales, between-group differences did not reach significance, possibly due to lack of power because of the small sample size. Cumulative yoga minutes were correlated with improvement in outcome measures. LIMITATION This dosing study did not include a non-yoga control. CONCLUSIONS Improvement in psychological symptoms correlated with cumulative yoga practice. Both interventions reduced symptoms of depression and anxiety and increased feelings of positivity. The time commitment for yoga practice needs to be weighed against benefits when designing yoga interventions.
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Nauphal M, Mischoulon D, Uebelacker L, Streeter C, Nyer M. Yoga for the treatment of depression: Five questions to move the evidence-base forward. Complement Ther Med 2019; 46:153-157. [PMID: 31519272 DOI: 10.1016/j.ctim.2019.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/04/2019] [Accepted: 08/14/2019] [Indexed: 12/28/2022] Open
Abstract
Yoga-based practices, derived from ancient Eastern mind-body practices, have grown in popularity in the West over the past several decades. Increasing evidence supports the antidepressant effects of yoga-based interventions (YBIs). However, despite yoga's promise as a potential treatment for depression, the literature to date is marked by substantial methodological limitations, which remain a barrier to the integration of YBIs into conventional clinical care. We highlight five key areas of study that need further investigation to fill crucial gaps in the literature-base to advance yoga research and yoga's potential as an effective evidence-based treatment for depression.
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Affiliation(s)
- Maya Nauphal
- Department of Psychology, Boston University, Boston MA, United States.
| | - David Mischoulon
- Department of Psychiatry, Harvard School of Medicine, Boston MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston MA, United States.
| | - Lisa Uebelacker
- Alpert Medical School, Brown University, Providence RI, United States; Butler Hospital, Providence RI, United States.
| | - Chris Streeter
- Department of Psychiatry, Boston University School of Medicine, Boston MA, United States; Department of Psychiatry, Boston Medical Center, Boston MA, United States; Department of Psychiatry, McLean Hospital, Belmont MA, United States; Department of Neurology, Boston University School of Medicine, Boston MA, United States; Department of Psychiatry, Edith Nourse Rogers Memorial Veterans Hospital, Bedford MA, United States.
| | - Maren Nyer
- Department of Psychiatry, Harvard School of Medicine, Boston MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston MA, United States.
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Nyer M, O'Hair CM, Hopkins LB, Roberg R, Norton R, Streeter C. Yoga as a Treatment for Depression: Applications for Mental Health Practitioners. Psychiatr Ann 2019. [DOI: 10.3928/00485713-20181203-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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