title: Treating major depression with yoga: A prospective, randomized, controlled pilot trial.
abstract: BACKGROUND
  Conventional pharmacotherapies and psychotherapies for major depression are associated with limited adherence to care and relatively low remission rates. Yoga may offer an alternative treatment option, but rigorous studies are few. This randomized controlled trial with blinded outcome assessors examined an 8-week hatha yoga intervention as mono-therapy for mild-to-moderate major depression.
  
  
  METHODS
  Investigators recruited 38 adults in San Francisco meeting criteria for major depression of mild-to-moderate severity, per structured psychiatric interview and scores of 14-28 on Beck Depression Inventory-II (BDI). At screening, individuals engaged in psychotherapy, antidepressant pharmacotherapy, herbal or nutraceutical mood therapies, or mind-body practices were excluded. Participants were 68% female, with mean age 43.4 years (SD = 14.8, range = 22-72), and mean BDI score 22.4 (SD = 4.5). Twenty participants were randomized to 90-minute hatha yoga practice groups twice weekly for 8 weeks. Eighteen participants were randomized to 90-minute attention control education groups twice weekly for 8 weeks. Certified yoga instructors delivered both interventions at a university clinic. Primary outcome was depression severity, measured by BDI scores every 2 weeks from baseline to 8 weeks. Secondary outcomes were self-efficacy and self-esteem, measured by scores on the General Self-Efficacy Scale (GSES) and Rosenberg Self-Esteem Scale (RSES) at baseline and at 8 weeks.
  
  
  RESULTS
  In intent-to-treat analysis, yoga participants exhibited significantly greater 8-week decline in BDI scores than controls (p-value = 0.034). In sub-analyses of participants completing final 8-week measures, yoga participants were more likely to achieve remission, defined per final BDI score ≤ 9 (p-value = 0.018). Effect size of yoga in reducing BDI scores was large, per Cohen's d = -0.96 [95%CI, -1.81 to -0.12]. Intervention groups did not differ significantly in 8-week change scores for either the GSES or RSES.
  
  
  CONCLUSIONS
  In adults with mild-to-moderate major depression, an 8-week hatha yoga intervention resulted in statistically and clinically significant reductions in depression severity.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01210651.
authors.affiliation: Department of Psychiatry, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Sudha
authors.identifier: http://orcid.org/0000-0002-1133-0115
authors.initials: S
authors.lastname: Prathikanti
authors.affiliation: Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Renee
authors.initials: R
authors.lastname: Rivera
authors.affiliation: Department of Psychiatry, Weill Cornell Medicine, Cornell University, New York, New York, United States of America.
authors.forename: Ashly
authors.initials: A
authors.lastname: Cochran
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Jose Gabriel
authors.initials: JG
authors.lastname: Tungol
authors.affiliation: Department of Psychiatry, Veterans Affairs Long Beach Healthcare System, Long Beach, California, United States of America.
authors.forename: Nima
authors.initials: N
authors.lastname: Fayazmanesh
authors.affiliation: Fuss Ueber Kopf Yoga Studio, Svastha Yoga Therapy Program, Stuttgart, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Weinmann
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D015013:Yoga