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      Yoga on Our Minds: A Systematic Review of Yoga for Neuropsychiatric Disorders

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          Abstract

          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.

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          Most cited references34

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          The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys

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            Yoga therapy as an add-on treatment in the management of patients with schizophrenia--a randomized controlled trial.

            Treatment of schizophrenia has remained unsatisfactory despite the availability of antipsychotics. This study examined the efficacy of yoga therapy (YT) as an add-on treatment to the ongoing antipsychotic treatment. Sixty-one moderately ill schizophrenia patients were randomly assigned to YT (n = 31) and physical exercise therapy (PT; n = 30) for 4 months. They were assessed at baseline and 4 months after the start of intervention, by a rater who was blind to their group status. Forty-one subjects (YT = 21; PT = 20) were available at the end of 4 months for assessment. Subjects in the YT group had significantly less psychopathology than those in the PT group at the end of 4 months. They also had significantly greater social and occupational functioning and quality of life. Both non-pharmacological interventions contribute to reduction in symptoms, with YT having better efficacy.
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              Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life.

              There are potential benefits of mind-body techniques on cognitive function because the techniques involve an active attentional or mindfulness component, but this has not been fully explored. To determine the effect of yoga on cognitive function, fatigue, mood, and quality of life in seniors. Randomized, controlled trial comparing yoga, exercise, and wait-list control groups. One hundred thirty-five generally healthy men and women aged 65-85 years. Participants were randomized to 6 months of Hatha yoga class, walking exercise class, or wait-list control. Subjects assigned to classes also were asked to practice at home. Outcome assessments performed at baseline and after the 6-month period included a battery of cognitive measures focused on attention and alertness, the primary outcome measures being performance on the Stroop Test and a quantitative electroencephalogram (EEG) measure of alertness; SF-36 health-related quality of life; Profile of Mood States; Multi-Dimensional Fatigue Inventory; and physical measures related to the interventions. One hundred thirty-five subjects were recruited and randomized. Seventeen subjects did not finish the 6-month intervention. There were no effects from either of the active interventions on any of the cognitive and alertness outcome measures. The yoga intervention produced improvements in physical measures (eg, timed 1-legged standing, forward flexibility) as well as a number of quality-of-life measures related to sense of well-being and energy and fatigue compared to controls. There were no relative improvements of cognitive function among healthy seniors in the yoga or exercise group compared to the wait-list control group. Those in the yoga group showed significant improvement in quality-of-life and physical measures compared to exercise and wait-list control groups.
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                Author and article information

                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                12 October 2012
                25 January 2013
                2012
                : 3
                : 117
                Affiliations
                [1] 1Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine Durham, NC, USA
                [2] 2Indian Council of Medical Research Center for Advanced Research in Yoga and Patanjali Research Foundation Bengaluru, India
                [3] 3Duke Institute for Brain Sciences Durham, NC, USA
                Author notes

                Edited by: Susan A. Everson-Rose, University of Minnesota, USA

                Reviewed by: Dusan Kolar, Queen’s University, Canada; Felicia Iftene, Queens University, Canada

                *Correspondence: Meera Balasubramaniam, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. e-mail: meera.balasubramaniam@ 123456duke.edu ; P. Murali Doraiswamy, DUMC-3018, Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA. e-mail: dorai001@ 123456mc.duke.edu

                This article was submitted to Frontiers in Affective Disorders and Psychosomatic Research, a specialty of Frontiers in Psychiatry.

                Article
                10.3389/fpsyt.2012.00117
                3555015
                23355825
                c95d6d6b-bf38-4c26-bb4d-def28f4265c9
                Copyright © 2013 Balasubramaniam, Telles and Doraiswamy.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

                History
                : 09 September 2012
                : 20 December 2012
                Page count
                Figures: 2, Tables: 10, Equations: 0, References: 49, Pages: 16, Words: 9976
                Categories
                Psychiatry
                Review Article

                Clinical Psychology & Psychiatry
                yoga,meditation,depression,schizophrenia,cognition,adhd,clinical trials,alternative medicine

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