A review of clinical trials of yoga in depression published up to 2004 found 5 randomised controlled trials, each of which utilised different forms of yoga interventions and participants with mild to severe symptoms. (Pilkington 2005) All trials reported positive findings although various methodological details were missing. No adverse effects were reported with the exception of fatigue and breathlessness in participants in one study. It was concluded that the initial indications are of potentially beneficial effects of yoga interventions on depressive disorders. Several of the interventions may not be feasible in those with reduced or impaired mobility. Nevertheless, further investigation of yoga as a therapeutic intervention was considered valuable.
Subsequently, 2 further RCTs have been published, both of which were conducted in India. In the first, 69 older adults (60+ years) in a residential home participated in yoga classes or received Ayurveda or were randomised to a wait list group to be offered treatment at a later stage (Krishnamurthy 2007). Yoga consisted of regulated breathing, physical postures (asanas) and relaxation for 75 minutes 6 times weekly over a period of 6 months. Scores on the short version of the Geriatric Depression Scale decreased for those in the yoga group but no significant changes were seen in other groups. This trial had the benefit of a long duration of treatment as is often required in depression but the attrition rate in the Ayurvda group was considerable (11 patients discontinued treatment). The groups were reported to be well-matched initially but the actual numbers participating were small and the context of the study limits applicability in practice. The second study included patients between 18 and 45 years of age with a DSM IV diagnosis of depression (Sharma 2005). Fifteen patients participated in Sahaj Yoga (a meditation-based form of yoga) while 15 participated in a control intervention which provided the same environment and attention as yoga subjects. However, actual meditation was not practiced and participants were instructed to simply place their hands at different positions as during Sahaj Yoga practice and thereafter sit quietly with their eyes closed. The intervention lasted for 30 minutes 3 times weekly for 8 weeks. Both groups continued on their current medication. A significant decrease in scores on the Hamilton rating scale for depression was reported in both groups but the percentage improvement in the Sahaj Yoga group was significantly higher.The number of patients who went into remission (scores of 7 or less) after two months of intervention were also significantly higher in the yoga group. Further outcomes from this study were reported in Sharma et al 2006. Trials of yoga conducted in a Western health context are still required in order to see if these preliminary positive results are translated into practice.
Systematic reviews
Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. Journal of Affective Disorders. 2005, 89(1-3):13-24. [PubMed abstract] [DARE structured abstract]
Randomized controlled trials (RCTs)
Krishnamurthy MN, Telles S. Assessing depression following two ancient Indian interventions: effects of yoga and ayurveda on older adults in a residential home. Journal of Gerontological Nursing. 2007, 33(2):17-23. [PubMed abstract]
Sharma VK, Das S, Mondal S, Goswampi U, Gandhi A. Effect of Sahaj Yoga on depressive disorders. Indian Journal of Physiology and Pharmacololy. 2005, 49(4):462-8. [PubMed abstract]
Sharma VK, Das S, Mondal S, Goswami U, Gandhi A. Effect of Sahaj Yoga on neuro-cognitive functions in patients suffering from major depression. Indian Journal of Physiology and Pharmacololy. 2006, 50(4):375-83. [PubMed abstract]
Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga intervention for young adults with elevated symptoms of depression. Alternative Therapies in Health and Medicine. 2004, 10(2):60-3. (included in systematic review above) [PubMed abstract]
Other studies of interest
Shapiro D, Cook IA, Davydov DM, Ottaviani C, Leuchter AF, Abrams M. Yoga as a complementary treatment of depression: effects of traits and moods on treatment outcome. Evidence-based Complementary and Alternative Medicine. 2007, 4(4):493-502. [Full text]
Link back to 2008 Annual evidence update on CAM in depression
