Yoga and Mental Health: Promising Road Ahead, but Proceed with Caution

Article excerpt

Byline: M. Keshavan, N. Rao, T.S.S.. Rao

The art of yoga is thousands of years old. Early indications of yogic postures are seen in the remains of the Indus Valley Civilization. While early texts such as Patanjali's Yoga Sutras (C. 400 AD) describe the basic principles of yoga, the techniques of this discipline have evolved over the last two millennia. Over the past several decades, yogic practice has rapidly become a burgeoning global industry with several variations being taught and practiced around the world. By contrast to the art of yoga however, the science of yoga and its application to mental health issues is relatively recent. The articles in this special issue of the Indian Journal of Psychiatry provide glimpses of emerging new research on treatment of various neuropsychiatric disorders. The articles examine different aspects of yoga-based interventions in different neuropsychiatric disorders ranging from validating a module to examining its efficacy to understanding the biological basis of its effects. While individual papers are of interest to specific disciplines, this collation is likely to provide a synthesis of diverse developing concepts and will be of interest to the reader community of the journal.

The first two papers discuss about designing and validating yoga modules for use in the patient population. Hariprasad et al . [sup][1] describe the development of a yoga module for use in elderly and Naveen et al . [sup][2] describe validation and feasibility of a yoga module for depression. Using traditional and contemporary yogic literature, these authors developed yoga modules and then examined the feasibility of their use in pilot studies. Limitations like a small number of subjects, inability to perform asanas and inability to remember complete sequences of asanas need to be addressed in future. These studies provide validated modules, which can be tested for their efficacy in patient populations. [sup][1]

Four subsequent articles examine the efficacy of yoga as a treatment for different psychiatric disorders. Sivakumar et al. examined the benefits of yoga-based intervention compared with waitlist control group on cognitive function in the residents of elderly homes and report significant improvement in cognitive functions following yoga. [sup][3] In addition, these residents also had a significant improvement in quality-of-life and total sleep quality. [sup][4] In the study by Gangadhar et al ., [sup][5] authors examined the efficacy of yoga intervention in depression. The study findings are interesting as yoga had better efficacy than pharmacotherapy and was devoid of side-effects. Manjunath et al . [sup][6] examined the effect of add-on yoga therapy or physical exercise along with standard pharmacotherapy in treatment of in-patients with psychosis. Though, both groups were comparable at the end of 2 weeks yoga figured better than exercise in clinical improvement at the end of 6 weeks. These studies demonstrate the application of scientific rigour used in pharmacological clinical trials to yoga research. For example, authors followed a randomized trial design and used valid neuropsychological tests to measure cognitive functions comparable with contemporary pharmacological trials. Such methodological rigor is necessary for inclusion of yoga-based interventions into the physician's treatment options. These studies indicate the potential of yoga as a treatment for psychiatric disorders alone or in combination with pharmacotherapy. Future studies need to address limitations like absence of an active comparison group or bias of treatment selection by patients for further acceptance by the scientific community.

Three subsequent papers in the supplement describe the applicability of yoga in special populations. Hariprasad et al . [sup][7] report the feasibility of yoga as a therapy in children with attention deficit hyperactive disorder. Their report establishes the potential of yoga in the treatment of childhood psychiatric disorders. …

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