Yoga May Have Positive Effects On Major Psychiatric Disorders, Including Depression, Schizophrenia, ADHD And Sleep Complaints
Medical News Today January 29, 2013
Yoga has positive effects on mild depression and sleep complaints, even in the absence of drug treatments, and improves symptoms associated with schizophrenia and ADHD in patients on medication, according to a systematic review of the exercise on major clinical psychiatric disorders.
Published in the open-access journal, Frontiers in Psychiatry, the review of more than one hundred studies focusing on 16 high-quality controlled studies looked at the effects of yoga on depression, schizophrenia, ADHD, sleep complaints, eating disorders and cognition problems.
Yoga in popular culture
Yoga is a popular exercise and is practiced by 15.8 million adults in the United States alone, according to a survey by the Harris Interactive Service Bureau, and its holistic goal of promoting psychical and mental health is widely held in popular belief.
"However, yoga has become such a cultural phenomenon that it has become difficult for physicians and patients to differentiate legitimate claims from hype," wrote the authors in their study. "Our goal was to examine whether the evidence matched the promise."
Benefits of the exercise were found for all mental health illnesses included in the review, except for eating disorders and cognition problems as the evidence for these was conflicting or lacking.
Dr. P. Murali Doraiswamy, a professor of psychiatry and medicine at Duke University Medical Center, US, and author of the study, explained that the emerging scientific evidence in support of the 5,000 year old Indian practice on psychiatric disorders is "highly promising" and showed that yoga may not only help to improve symptoms, but also may have an ancillary role in the prevention of stress-related mental illnesses.
The review found evidence from biomarker studies showing that yoga influences key elements of the human body thought to play a role in mental health in similar ways to that ofantidepressants and psychotherapy. One study found that the exercise affects neurotransmitters, inflammation, oxidative stress, lipids, growth factors and second messengers.
Unmet need among mental health patients
Depression alone affects more than 350 million people globally and is the leading cause of disability worldwide, according to the World Health Organization (WHO). On World Mental Health Day last year, the WHO called for improved access to treatments.
While there has been an increase in the number of medications available for mental health disorders, many of which can be life saving for patients, there remains "a considerable unmet need," according to Dr. Meera Balasubramaniam, lead author of the study, who is also based at Duke University, US.
Poor compliance and relapse as well as treatment resistance are growing problems, and medications are expensive and can leave patients with significant side effects.
The Primary Care study, carried out by WHO, found that 60% of patients were still depressed after a year of being treated with an anti-depressant and a National Institute of Mental Health funded research showed remission in only one-third of patients.
"The search for improved treatments, including non-drug based, to meet the holistic needs of patients is of paramount importance and we call for more research into yoga as a global priority," said Doraiswamy. "If the promise of yoga on mental health was found in a drug, it would be the best selling medication world-wide," he added.
There are many benefits associated with practicing yoga for improving mental health, including, fewer side effects, relatively low cost, generally good access and the improvement of physical fitness, added the authors.
The authors also note that while the results are promising, the findings should be viewed as preliminary because all studies of yoga to date have consisted of small samples, and more rigorous research will be needed before the exercise can be applied to help patients with mental health disorders.
Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders
- 1Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- 2Indian Council of Medical Research Center for Advanced Research in Yoga and Patanjali Research Foundation, Bengaluru, India
- 3Duke Institute for Brain Sciences, Durham, NC, USA
Background: The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being.
Objective: To systematically examine the evidence for efficacy of yoga in the treatment of selected major psychiatric disorders.
Methods: Electronic searches of The Cochrane Central Register of Controlled Trials and the standard bibliographic databases, MEDLINE, EMBASE, and PsycINFO, were performed through April 2011 and an updated in June 2011 using the keywords yoga AND psychiatry OR depression OR anxiety OR schizophrenia OR cognition OR memory OR attention AND randomized controlled trial (RCT). Studies with yoga as the independent variable and one of the above mentioned terms as the dependent variable were included and exclusion criteria were applied.
Results: The search yielded a total of 124 trials, of which 16 met rigorous criteria for the final review. Grade B evidence supporting a potential acute benefit for yoga exists in depression (four RCTs), as an adjunct to pharmacotherapy in schizophrenia (three RCTs), in children with ADHD (two RCTs), and Grade C evidence in sleep complaints (three RCTs). RCTs in cognitive disorders and eating disorders yielded conflicting results. No studies looked at primary prevention, relapse prevention, or comparative effectiveness versus pharmacotherapy.
Conclusion: There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health.