Abstract
Background: Obsessive-compulsive disorder (OCD) is often a life-long disorder with high psychosocial impairment. Serotonin reuptake inhibitors (SRIs) are the only FDA approved drugs, and approximately 50% of patients are non-responders when using a criterion of 25% to 35% improvement with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). About 30% are non-responders to combined first-line therapies (SRIs and exposure and response prevention). Previous research (one open, one randomized clinical trial) has demonstrated that Kundalini Yoga (KY) meditation can lead to an improvement in symptoms of obsessive-compulsive severity. We expand here with a larger trial.Design: This trial compared two parallel run groups [KY vs. Relaxation Response meditation (RR)]. Patients were randomly allocated based on gender and Y-BOCS scores. They were told two different (unnamed) types of meditation would be compared, and informed if one showed greater benefits, the groups would merge for 12 months using the more effective intervention. Raters were blind in Phase One (0–4.5 months) to patient assignments, but not in Phase Two.Main Outcome Measures: Primary outcome variable, clinician-administered Y-BOCS. Secondary scales: Dimensional Yale-Brown Obsessive Compulsive Scale (clinician-administered), Profile of Mood Scales, Beck Anxiety Inventory, Beck Depression Inventory, Clinical Global Impression, Short Form 36 Health Survey.Results: Phase One: Baseline Y-BOCS scores: KY mean = 26.46 (SD 5.124; N = 24), RR mean = 26.79 (SD = 4.578; N = 24). An intent-to-treat analysis with the last observation carried forward for dropouts showed statistically greater improvement with KY compared to RR on the Y-BOCS, and statistically greater improvement on five of six secondary measures. For completers, the Y-BOCS showed 40.4% improvement for KY (N = 16), 17.9% for RR (N = 11); 31.3% in KY were judged to be in remission compared to 9.1% in RR. KY completers showed greater improvement on five of six secondary measures. At the end of Phase Two (12 months), patients, drawn from the initial groups, who elected to receive KY continued to show improvement in their Y-BOCS scores.Conclusion: KY shows promise as an add-on option for OCD patients unresponsive to first line therapies. Future studies will establish KY’s relative efficacy compared to Exposure and Response Prevention and/or medications, and the most effective treatment schedule.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01833442.
Highlights
Obsessive-Compulsive Disorder (OCD) is defined by intrusive, unpleasant, and recurrent thoughts that are often recognized to be irrational and excessive, and are often accompanied by repetitive behaviors performed in an attempt to eliminate the anxiety caused by the obsessions [1]
An ITT last observation carried forward (LOCF) analysis showed the superiority of Kundalini Yoga (KY) on the primary outcome measure (Y-BOCS) and the DY-BOCS, Profile of Mood Scales (POMS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI)
Both treatments were well tolerated. The findings in this trial are comparable to the prior open trial [12] and the randomized trial [13] using this KY protocol for treating OCD
Summary
Obsessive-Compulsive Disorder (OCD) is defined by intrusive, unpleasant, and recurrent thoughts (obsessions) that are often recognized to be irrational and excessive, and are often accompanied by repetitive behaviors (compulsions) performed in an attempt to eliminate the anxiety caused by the obsessions [1]. The World Health Organization reports that OCD is one of the ten most disabling disorders worldwide [5]. Both behavioral and pharmaceutical interventions have demonstrated efficacy. Exposure and response prevention (ERP) is considered to be the most efficacious cognitive behavioral therapy (CBT) for treating OCD [6]. The efficacy of ERP for OCD has been evaluated in various meta-analyses in recent decades, reporting large effects sizes in comparison to waiting list groups (mean d = 1.30) [7]. Previous research (one open, one randomized clinical trial) has demonstrated that Kundalini Yoga (KY) meditation can lead to an improvement in symptoms of obsessive-compulsive severity.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
