Hatha yoga for acute, chronic and/or treatment-resistant mood and anxiety disorders: A systematic review and meta-analysis
Open accessAbstract
BACKGROUND: The aim of this study was to systematically investigate the effectiveness of hatha yoga in treating acute, chronic and/or treatment-resistant mood and anxiety disorders. METHODS: Medline, Cochrane Library, Current Controlled Trials, Clinical Trials.gov, NHR Centre for Reviews and Dissemination, PsycINFO and CINAHL were searched through June 2018. Randomized controlled trials with patients with mood and anxiety disorders were included. Main outcomes were continuous measures of severity of mood and anxiety symptoms. Cohen's d was calculated as a measure of effect size. Meta-analyses using a random effects model was applied to estimate direct comparisons between yoga and control conditions for depression and anxiety outcomes. Publication bias was visually inspected using funnel plots. RESULTS: Eighteen studies were found, fourteen in acute patients and four in chronic patients. Most studies were of low quality. For depression outcomes, hatha yoga did not show a significant effect when compared to treatment as usual, an overall effect size of Cohen's d -0.64 (95% CI = -1.41, 0.13) or to all active control groups, Cohen's d -0.13 (95% CI = -0.49, 0.22). A sub-analysis showed that yoga had a significant effect on the reduction of depression compared to psychoeducation control groups, Cohen's d -0.52 (95% CI = -0.96, -0.08) but not to other active control groups, Cohen's d 0.28 (95% CI = -0.07, 0.63) For studies using a follow-up of six months or more, hatha yoga had no effect on the reduction of depression compared to active control groups, Cohen's d -0.14 (95% CI = -0.60, 0.33). Regarding anxiety, hatha yoga had no significant effect when compared to active control groups, Cohen's d -0.09 (95% CI = -0.47, 0.30). The I2 and Q-statistic revealed heterogeneity amongst comparisons. Qualitative analyses suggest some promise of hatha yoga for chronic populations. CONCLUSIONS: The ability to draw firm conclusions is limited by the notable heterogeneity and low quality of most of the included studies. With this caveat in mind, the results of the current meta-analysis suggest that hatha yoga does not have effects on acute, chronic and/or treatment-resistant mood and anxiety disorders compared to treatment as usual or active control groups. However, when compared to psychoeducation, hatha yoga showed more reductions in depression. It is clear that more high-quality studies are needed to advance the field.
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A recent meta-analysis concluded that most studies of yoga for depression were of low methodological quality.
“However, a recent meta‐analysis of the effectiveness of yoga for depression concluded that most studies were of low methodological quality, thereby making it difficult to draw firm conclusions about yoga's effectiveness for depression (Vollbehr et al., 2018).”
From A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial (2020) · cites this paper as Vollbehr et al., 2018
There is a need for additional high-quality research on yoga as a treatment for depression.
“and a need for additional high‐quality research (Vollbehr et al., 2018)”
From A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial (2020) · cites this paper as Vollbehr et al., 2018
The methodological quality of most initial clinical studies of yoga for depression is low.
“the low methodological quality of most of this work suggests caution in interpreting the results”
From A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial (2020) · cites this paper as Vollbehr et al., 2018
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“, 2013), the low methodological quality of most of this work suggests caution in interpreting the results and a need for additional high-quality research (Vollbehr et al., 2018).”
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- Authors
- Vollbehr, N. K., Bartels-Velthuis, A. A., Nauta, M. H., Castelein, S., Steenhuis, L. A., Hoenders, H. J. R., & Ostafin, B. D.
- Affiliations
- University of Groningen (NL)
- Corresponding author
- Vollbehr, Nina K.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-10-01
- Volume
- 13
- Issue
- 10
- Pages
- e0204925
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6166972
- OpenAlex
- W2894595495
- Cited by
- 69
- References
- 110
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 12 · 2021: 14 · 2020: 8 · 2019: 7
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-05-02)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Universitair Medisch Centrum Groningen
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- hatha yoga, depression, anxiety disorders, mood disorders, treatment-resistant depression, chronic depression, acute depression, yoga therapy, psychoeducation, active control groups, usual care, symptom severity
- MeSH terms
- Acute Disease, Adult, Anxiety Disorders, Chronic Disease, Clinical Trials as Topic, Female, Humans, Male, Middle Aged, Quality of Life, Yoga, Treatment Outcome, Mood Disorders, Young Adult
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