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Psychological Function, Iyengar Yoga, and Coherent Breathing

A Randomized Controlled Dosing Study

SCOTT, TAMMY M. PhD; GERBARG, PATRICIA L. MD; SILVERI, MARISA M. PhD; NIELSEN, GREYLIN H.; OWEN, LIZ; NYER, MAREN PhD; BROWN, RICHARD P. MD; STREETER, CHRIS C. MD

Journal of Psychiatric Practice: November 2019 - Volume 25 - Issue 6 - p 437–450
doi: 10.1097/PRA.0000000000000435
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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 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.

SCOTT: Department of Psychiatry, Boston University School of Medicine, and Department of Psychiatry, Boston Medical Center, Friedman School of Nutrition Science and Policy, Tufts University, and Tufts University School of Medicine, Boston, MA

GERBARG: Department of Psychiatry, New York Medical College, Valhalla, NY

SILVERI: Department of Psychiatry, Harvard School of Medicine, Boston, MA, and Department of Psychiatry, McLean Hospital, Belmont, MA

NIELSEN and OWEN: Departments of Psychiatry and Neurology, Boston University School of Medicine, Boston, MA

NYER: Department of Psychiatry, Harvard School of Medicine, and Department of Psychiatry, Massachusetts General Hospital, Boston, MA

BROWN: Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY

STREETER: Departments of Psychiatry and Neurology, Boston University School of Medicine, Department of Psychiatry, Harvard School of Medicine, and Department of Psychiatry, Boston Medical Center, Boston, MA, Department of Psychiatry, McLean Hospital, Belmont, MA, and Department of Psychiatry, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA

Supported by grants R21AT004014 and R01AT007483 from the National Center for Complementary and Integrated Health to C.C.S.; grants U11RR025771 and M01RR00533 from the Boston University Clinical and Translational Science Institute (CTSI) to C.C.S.; and grant K23AT008043 from the General Clinical Research Unit at Boston University Medical Center to C.C.S. and M.N.

R.P.B. and P.L.G. teach and have published Breath-Body-Mind, a multicomponent program that includes coherent breathing. C.C.S. is certified to teach Breath-Body-Mind. The other authors declare no conflicts of interest.

Please send correspondence to: Chris C. Streeter, MD, Boston University School of Medicine, 85 East Newton Street, M-915A, Boston, MA 02118 (e-mail: streeter@bu.edu).

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