A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings

Nyer, Maren; Gerbarg, Patricia L.; Silveri, Marisa M.; Johnston, Jennifer M.; Scott, Tammy; Nauphal, Maya; Owen, Liz; Nielsen, Greylin H; Mischoulon, David; Brown, Richard P.; Fava, Maurizio; Streeter, Chris C.

doi:10.1016/j.ctim.2018.02.006

Cited by 25 publications

(22 citation statements)

References 23 publications

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“…23 Preliminary evidence suggests that it may even benefit more severe depression and even alleviate suicidal ideation. 24 It is noted to be well tolerated, with only mild and infrequent adverse events linked to physical fitness being reported, 24 and evidence for sustained benefit 3 to 6 months postintervention. 25 In contrast, the role of yoga in the treatment of bipolar depression is significantly understudied.…”

Section: Yoga For Depressionmentioning

confidence: 99%

Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé

et al. 2020

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Objective: Patients with depression frequently experience persistent residual symptoms even with optimal interventions. These patients often use complementary treatments, including yoga, as a preferred alternative or adjunctive treatment. There is evidence for the benefit of yoga for depression, but this has not been rigorously evaluated, particularly in bipolar depression. We aimed to determine the feasibility and benefit of manualized breathing-focused yoga in comparison to psychoeducation as augmentation to pharmacotherapy for improving residual symptoms of depression in unipolar and bipolar patients. Methods: Using a randomized single-blind crossover design, 72 outpatients with unipolar or bipolar depression were augmented with the two 8-week interventions at separate times, as add-ons to current first-line antidepressants and mood stabilizers. The primary outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). Due to the high dropout of participants after crossover at Week 8, analysis focused on between-group comparisons of yoga and psychoeducation during the initial 8 weeks of the study. Results: There was a significant decline in depressive symptoms, as measured by the MADRS, following 8 weeks of yoga. However, there was no significant difference in MADRS ratings between intervention groups. Similar improvements in self-rated depressive symptoms and well-being were also observed across time. Conclusions: Both yoga and psychoeducation may improve residual symptoms of unipolar and bipolar depression as add-on to medications. In-class group sessions and long study durations may reduce feasibility for this population. Larger trials with parallel group design and shorter duration may be more feasible.

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Section: Yoga For Depressionmentioning

confidence: 99%

Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé

et al. 2020

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“…This study used a manualized yoga intervention that was conducted by certified Iyengar yoga instructors under the supervision of the principal investigator, whose fidelity assessments ensured that the classes adhered to the protocol. 19 The participants were compliant with group assignments so that the HDG received significantly more yoga classes, yoga homework, and total yoga minutes that the LDG. The psychological instruments and mood scales used were valid and reliable.…”

Section: Strengthsmentioning

confidence: 99%

Psychological Function, Iyengar Yoga, and Coherent Breathing: A Randomized Controlled Dosing Study

Scott

Gerbarg

Silveri

et al. 2019

Journal of Psychiatric Practice

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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 Exerciseinduced 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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“…There is some preliminary evidence that yoga-based interventions may be a promising non-pharmacological option for depressive symptoms during pregnancy, especially for mild depression, as noted in a meta-analysis that included six studies (405 pregnant mothers) (Ng 2019). Evidence is also emerging to support the usefulness of yoga as monotherapy for mild to moderate depression, as demonstrated by a few good-quality RCTs (Prathikanti 2017; Nyer 2018). One of these RCTs found that a 12-week Iyengar yoga and coherent breathing programme was a helpful solo intervention for resolving suicidal ideations in people with major depressive disorder.…”

Section: Yoga In Psychiatry: the Evidence–basementioning

confidence: 99%

“…One of these RCTs found that a 12-week Iyengar yoga and coherent breathing programme was a helpful solo intervention for resolving suicidal ideations in people with major depressive disorder. It also reported that the most common adverse event associated with yoga practice was musculoskeletal pain, which resolved over the study period (Nyer 2018).…”

Section: Yoga In Psychiatry: the Evidence–basementioning

confidence: 99%

Yoga and mental health: what every psychiatrist needs to know

2022

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SUMMARY Yoga was developed primarily as a tool for self-mastery and spiritual progress. However, over the past few decades, the therapeutic applications of yoga in mental healthcare have been explored with promising results. This article aims to inform psychiatrists about the clinical usefulness of yoga for mental disorders. We discuss the rationale and latest evidence base for the use of yoga in psychiatric practice, including the neurobiological mechanisms and indications and contraindications for yoga therapy. We suggest practical yoga techniques that can be used as an add-on for managing common psychiatric conditions. Finally, we discuss the setting up and running of yoga clinical services in a tertiary psychiatric hospital in India and explore what can be learnt to facilitate yoga as a therapeutic approach in the Western world.

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A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings

Cited by 25 publications

References 23 publications

Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé

Breathing-focused Yoga as Augmentation for Unipolar and Bipolar Depression: A Randomized Controlled Trial: Le yoga axé sur la respiration comme traitement d’appoint pour la dépression unipolaire et bipolaire: Un essai randomisé contrôlé

Psychological Function, Iyengar Yoga, and Coherent Breathing: A Randomized Controlled Dosing Study

Yoga and mental health: what every psychiatrist needs to know

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