Abstract

The major depressive disorder is one of the most common mental illnesses worldwide. Current treatment standards recommend a combined therapy with medication and psychotherapy. As an additive component and to further improvements in treatment, physical activity such as yoga may be integrated into conventional treatment. This study investigates the impact of a 3-month body-oriented yoga in patients with major depressive disorder (MDD). In total, n = 83 patients were included. An intervention group received a vigorous Ashtanga-Yoga three times a week. The waiting-list control group obtained a treatment as usual (TAU). As a primary outcome depression scores (Beck Depression Inventory-II (BDI-II), Montgomery Asberg Depression Rating Scale (MADRS)) were tested at three time points. Secondary outcome was the positive and negative affect [Positive and Negative Affect Scale (PANAS)] and remission rates. To analyze the data, multilevel models and effect sizes were conducted. The results showed an improvement in BDI-II scores for both groups over time [γ = − 3.46, t(165) = − 7.99, p < 0.001] but not between groups [γ = 0.98, t(164) = 1.12, p = 0.263]. An interaction effect (time x group) occurred for MADRS [γ = 2.10, t(164) = 2.10, p < 0.038]. Positive affects improved over time for both groups [γ = 1.65, t(165) = 4.03, p < 0.001]. Negative affects decreased for all over time [γ = − 1.00, t(165) = − 2.51, p = 0.013]. There were no significant group differences in PANAS. Post hoc tests revealed a greater symptom reduction within the first 6 weeks for all measurements. The effect sizes for depression scores showed a positive trend. Remission rates indicated a significant improvement in the yoga group (BDI-II: 46.81%, MADRS: 17.02%) compared to the control group (BDI: 33.33%, MADRS: 8.33%). The findings suggest that there is a trendsetting additive effect of Ashtanga-Yoga after 3 months on psychopathology and mood with a greater improvement at the beginning of the intervention. Further research in this field can help to achieve more differentiated results.

Highlights

  • Affective disorders have a high prevalence worldwide in the general population [1] with more than 40.27 million people in the European region suffering from depressive syndromes [1, 2]

  • For Beck Depression Inventory-II (BDI-II) scores, the mean change score over the intervention period of 12 weeks declined by 7.77 points [t(162) = 4.52, SE = 1.14, p < 0.001] for the yoga group compared to the control group with a decline by 5.81 points [t(162) = 4.46, SE = 1.30, p < 0.001]

  • For the Positive and Negative Affect Scale (PANAS) positive, a negative indicator showed that the extent of positive affects in both groups changed by -3.11 points [t(162) = 4–2.85, SE = 1.09, p = 0.014] for the yoga group and by − 3.53 [t(162) = − 2.83, SE = 1.25, p = 0.014] in the control group over 12 weeks

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Summary

Introduction

Affective disorders have a high prevalence worldwide in the general population [1] with more than 40.27 million people in the European region suffering from depressive syndromes [1, 2]. European Archives of Psychiatry and Clinical Neuroscience (2021) 271:1217–1229. In this context, research addresses the integration of physical activity and mindfulness-based treatments in the treatment of MDD. Many interventional trials have so far demonstrated that regular physical activity has a reducing effect on depressive symptoms [4, 12,13,14,15] in addition to positive physical benefits, and that exercise improves the general well-being in the case of psychological disorders [16, 17]. In addition to conventional cardio training, yoga as a form of exercise is in the focus of scientific research [18, 19]. Yoga seems to be an alternative form of physical exercise in the treatment of psychological disorders and offers advantages in terms of adherence due to its increasing popularity in the western world

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