Yoga for Depression - Therapy with Yogatherapywithyoga.com/research.pdf · u Sudarshan Kriya Yoga...
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Yoga for Depression JANIS CARTER & GERARD BYRNE Department of Psychiatry University of Queensland [email protected] [email protected]
Transcript of Yoga for Depression - Therapy with Yogatherapywithyoga.com/research.pdf · u Sudarshan Kriya Yoga...
Yoga for Depression
JANIS CARTER & GERARD BYRNEDepartment of PsychiatryUniversity of Queensland
[email protected]@psychiatry.uq.edu.au
Background
u Increasing interest in complementary treatmentsfor depression
u Increasing interest in augmentation ofpharmacological treatments with non-pharmacological ones
u High levels of interest in Yogau Little evidence of the value of Yoga in mental
disorders
RCT: Yoga vs ECT vs Imipramine
u Sudarshan Kriya Yoga (SKY)– Daily 45 minute sessions once daily for six weeks
(breathing based)
u ECT– Modified bilateral ECT three times weekly until
HDRS <7 on two consecutive assessments
u Imipramine– 150mg nocte (no titration)
Janakiramaiah et al., Journal of Affective Disorders, 57: 255-259, 2000
RCT: Yoga vs ECT vs Imipramine
0
5
10
15
20
25
30
Wk 0 Wk 1 Wk 2 Wk3 Wk4
ECTImipramineYoga
HRSD-17
Janakiramaiah et al., Journal of Affective Disorders, 57: 255-259, 2000
N = 45
DSM-IVMDD
BaselineHDRS 24.8
Caveats
u Open labelled studyu No placebo groupu Cultural issues (Bangalore)
Yoga AugmentationFeasibility Study
u N = 8 males war veterans (mainly Vietnam)u Mean age: 60.25 years (range: 53 – 84)u PTSD + MDD (DSM-IV)u All on an SSRI (mainly sertraline)u Open label augmentation with Yogau Baseline self-rated CES-D score: 37 ± 12.39u Baseline clinician-rated HDRS score: 29.9 ± 7.5
Yoga Intervention
u Group Yoga – men onlyu Subjects in good physical healthu Conducted by an accredited Yoga instructoru Classes conducted once a week for an houru Yoga postures derived from instructions of
B.K.S. Iyengar – claimed to be specific fordepression
Upavista Konasana
Ardha Chandrasana
Ustrasana
Baddhakonasana
Viparita Dandasana
Salamba Sarvangasana
Yoga AugmentationIndividual CES-D* Scores over 6 weeks
0
10
20
30
40
50
60
1 2 3 4 5 6
Week*CES-D: Center for Epidemiologic Studies Depression Scale20 items, maximum score 60, > 22 = significant depression
Yoga AugmentationMean Self-Rated CES-D Score
0
5
10
15
20
25
30
3540
1 2 3 4 5 6
Week
Baseline mid-October 2002
Yoga AugmentationIndividual HDRS-17* Scores over 6 weeks
0
10
20
30
40
50
1 3 6Week*HDRS-17: Hamilton Depression Rating Scale17-item version; Maximum score 52
Yoga AugmentationIndividual HDRS-17* Scores over 6 weeks
0
10
20
30
40
50
1 3 6Week*HDRS-17: Hamilton Depression Rating Scale17-item version; Maximum score 52
Longer Term OutcomeContinued Yoga Augmentation
0
10
20
30
40
50
60
1 2 3 4 5 6 14 15 16 17 18 19 22 23 24 25
Gulf War IIEarly Jan 03
Week
Baseline mid-October 2002
CES-D Score
Putative Mechanisms
Diversion & distraction
Self-efficacy
Mastery
Social interaction
Aerobic fitness
Monoamines
Endorphins
Thermogenesis
RCT: Sertraline vs AerobicExercise vs Both
0
5
10
15
20
Sertraline AerobicExercise
Both
Before Treatment
After 16wks ofTreatment
HDRS-17N = 156DSM-IV MDDAge: 57
Blumenthal et al., Arch Intern Med 159: 2349-2356, 1999
F(2,152) = 0.61, p = 0.55
Future Plans
u Six-Week Randomized Controlled Trialu Veterans with PTSD + MDDu Yoga Augmentation of standard
psychiatric treatment (antidepressant +counselling)
u Control condition
