Get Permission Krishna and Das: Y oga and mental health: A controlled study of effectiveness


Introduction

"Yoga" means union, derived from Sanskrit literature Yuj. Or to join, and to direct and concentrate one's attention.1, 2 In earlier days Various practice of yoga was first introduced by Patanjali.2, 3 In yoga sutras, an eightfold path to awareness and enlightenment called ashtanga," described by Patanjali2, 4

In western countries nowadays yoga is considered an alternative holistic approach to maintain good health.5

Yoga integrates an individual's psychological and spiritual components to improve health, particularly stress-related problems.6 Earlier studies have evidenced that stress is responsible for the development of various diseases.7 Both yoga practices and clinical trials have been proven to reduce complications.

Various psychotic conditions are alleviated by yoga.8 Yoga influence one to relax, slow the breath and focus on the present. It balances the nervous system, to induce the flight-or-fight response and the relaxation response.9 Yoga can restore all physiological conditions and increases blood flow to the intestines and vital organs. Earlier one scientific study (10 h) introduced by Iyengar has shown improvement in self-reported acute mood states of depression traits.10, 11 Psychological problems impact susceptibility to causing of diseases.12, 13 Practicing yoga and meditation reflects and manage abnormalities aassociated with diseases.14, 15

In our study, we evaluate the effect of yoga in reducing the depression and also find out a relation between various socio-demographic parameters with a level of depression to improve the quality of life.

Materials and Methods

Study Setting

The study carried out at Vijayawada.

Study population

In total study population (84) only 60 were in included. 60 were distributed into two groups; study group (30) and control group (30).

Table 1
Group Pre-test Yoga Intervention Post-test
Study Given
Control Not given

Sampling criteria

Inclusion criteria

  1. Volunteers attending the yoga center.

  2. Volunteers who were interested and physically able to do Yoga.

  3. Volunteers who could come for follow up after one month.

  4. Volunteers between the age group of 18 - 60yrs.

  5. Volunteers who gave written informed consent.

Exclusion criteria

  1. Volunteers with severe psychiatric illness, neurological disorder and, other severe medical conditions.

  2. Volunteers who were practicing Yoga currently.

  3. Volunteers who were having the present history of substance abuse excluding nicotine.

Depression and quality of life assessed by specific methods.16, 17, 18, 19

Practicing of Yoga Therapy

Yoga module-45 mins duration by different asanas followed by;

  1. Breath awareness followed by 3 times OM chanting (2 mins)

  2. II.Breathing exercises: (5 mins)

  3. Standing postures: (3 mins)

  4. Full Yogic breathing (3 mins)

  5. Sitting postures: (2 mins)

  6. Prone and Supine postures (2 mins)

  7. Yoga Nidra ( 15mins)

  8. Pranayama (10 mins)

  9. PranavaJapa (3 mins)

Follow up

We followed through telephone and also maintained a register about the duration and the number of days of subjects Yoga practice.

Post assessment

Volunteers in the study and control group were evaluated at 4 weeks on depression and quality of life on the above- mentioned scales.

Data analysis

Compare the pre and post-test scores between groups (i.e. control and study group) on the level of depression and quality of life by’t’ test

Results and Observations

Table 2

Socio-demographic characteristics of Volunteers in both the groups

Variables Group P- value
Control (n=30) Experimental (n=30)
Number % Number %
Age < 35 yrs 15 50 16 53.3 .798
>35yrs 15 50 14 46.7
Sex Male 17 56.6 18 60
Female 13 43.3 12 40 .795
Education
Inter and below 14 46.7 12 40 .605
Above intermediate 16 53.3 18 60
Occupation
Earning 20 66.6 22 73.3 .576
Non earning 10 33.3 8 26.6
Marital status Married 19 63.3 22 73.3
Unmarried 11 36.6 8 26.6 .409

In both study and control groups peoples equally distributed respectively according to their age. In the study group, 53.3% of people were more than 35 years. We observed no significant difference in the age distribution of volunteers among the control and study group. There was male domination were seen in both study (60%) and control group (56.6%). Intermediate and below intermediate is the education level in both the groups. There was no statistically significant in the above parameters of both groups. In both the group more approximately 65% of people were earning and married.

Table 3

Depression scores of subjects –Before yoga

Group t-value p-value
Control (n=30) Study (n=30)
Mean ± S.D Mean ± S.D
Depression 10.70 ±3.48 11.50 ±4.10 0.813 0.419

We observed that the depression levels of volunteers in the control and study group didn't differ significantly (p=0.419, for depression). (Table 3)

Table 4

Quality of Life in both the groups with respect of domains

Domains Group t-value
Control (n=30) Study group(n=30) p-value
Mean ± S.D Mean ± S.D
1. Physical Health 14.10± 1.72 14.90 ±1.51 1.99 0.06
2. Psychological 10.23 ±1.59 10.93 ± 0.92 .099 0.92
3.Social Relationship 10.06 ± 1.08 10.40 ± 0.89 1.302 0.19
4. Environment 11.40 ±1.58 11.23 ± 1.04 .481 0.63

The present results revealed that there was no difference between the control and study group on the overall quality of life among volunteers attending the yoga center at the pre-test level. (Table 4)

Table 5

Relation between demographic variables and the level of depression

Depression Severe 19-22 Chi square value p-value
1 Variables Normal 0-7 Mild 8-13 Moderate 14-18
Number (%)
Age < 35 yrs 5 (38) 16 (51) 9 (60) 1 (50) 0.88 0.829
> 35 yrs 7 (62) 15 (49) 6 (40) 1 (50)
Sex Male 5 (38) 20 (64) 9 (60) 1 (50) 1.901 0.593
Female 7 (62) 11 (36) 6 (40) 1 (50)
Education 2.676 0.444
Inter and below 5 (38) 13 (41) 6 (40) 2 (100)
Above intermediate 7 (62) 18 (59) 9 (60) 0
Occupation 1.699 0.637
Earning 7 (62) 22 (71) 11 (73) 2 (100)
Non earning 5 (38) 9 (29) 4 (27) 0
Marital status married 10 (83) 19 (61) 11 (73) 1 (50) 2.402 0.493
Un married 2 (17) 12 (39) 4 (27) 1 (50)

The above finding shows that no relation between socio-demographic parameters and depression.

Table 6

Test scores of depression and quality of life in the control group (Pre and post).

Variables Control Group (n=30) t -value
Pre-test Post test p-valuee
Mean ± S.D Mean± S.D
Depression 10.70 ±3.48 10.46±3.15 1.756 0.09
Quality of life (Domains)
1. Physical Health 14.10 ± 1.72 13.70±1.12 1.795 0.08
2. Psychological Health 10.23 ± 1.59 10.16±0.46 0.254 0.80
3. Social Relationship 10.06 ± 1.08 9.83 ± 0.37 1.424 0.16
4. Environment 11.40 ± 1.58 10.83±0.46 1.876 0.07

The levels of depression and all the domains do not differ significantly between pre and post-assessments in the control group (p=0.09 respectively). (Table 6)

Table 7

Scores of depression and Quality of life in the study group.

Variables Study (n=30) t -value
Pre-test Post test p-value
Mean ± S.D Mean± S.D
Depression 11.50 ±4.10 6.40±2.71 11.721 <0.001*
Quality of life (Domains)
1. Physical Health 14.90±1.51 18.70±1.26 10.746 <0.001*
2. Psychological Health 10.20 ± 0.92 14.56±1.47 14.681 <0.001*
3. Social Relationship 10.40 ± 0.89 14.53± 0.86 18.492 <0.001*
4.Environment 11.23 ± 1.04 15.36±1.24 14.628 <0.001*
*significant

After post assessment, both depression and quality of life improved 11.50 vs 6.40 in the study group (p<0.001).

Table 8

Depression and quality of life between the groups at post-assessment

Parameters Groups
Control (n=23) Study (n=20) t-value p-value
Mean ± S.D Mean ± S.D
Depression 10.46 ±3.15 6.40 ±2.71 5.35 <0.001*
Quality of life (Domains)
1. Physical Health 13.70 ±1.14 18.70 ±1.26 16.03 <0.001*
2.Psychological Health 10.16 ±0.46 14.56 ±1.47 15.56 <0.001*
3.Social Relationship 9.83 ±0.37 14.53 ±0.86 27.38 <0.001*
4.Environment 10.83 ±0.46 15.36 ±1.24 19.09 <0.001*

Both in the control and study group, there was a significantly lower level of depression and higher quality after a Yoga intervention. (Table 8)

Discussion

The present study is to find out the better alternative method to reduce depression and improve the quality of life among volunteers attending the yoga center. The mean score of depression in the control group was 10.70 and in the study group was 11.50. In both groups, there was no statistically significant difference in depression levels of patients (p=0.449 respectively for depression). The Number of people shown an abnormal level of depression in both groups. These studies accordance with the previous findings reported by Choi et al., (2011).18

Our studies depict that, there was no significant difference between the control and study groups on the overall quality of life concerning four domains. There was no positive correlation between the various demographic variables and level of depression.

The pre and post-test mean scores of depression were 10.70 &10.46. Depression levels do not differ significantly between pre and post-assessments in the control group (p = 0.06 & p=0.09 respectively). All domains of quality of life did not differ significantly between pre and post-assessments in the control group. Whereas, depression level was also significantly lower at the post-assessment, 11.50 vs. 6.40 (p<0.00l) and also a significant improvement in the quality of life of all four domains in the study group. Our results were similar to Waelde et al (2004)20 & Lee et al (2004).21

The mean score of depression in the control & study group was 10.46 and 6.40. Quality of life was evaluated under four domains. All demographic parameters have different mean scores. Our findings stated that there was a significantly lower level of depression and significantly higher quality of life in the experimental group after a Yoga intervention.

Our finding correlates with the previous studies reported by Kozasa et al (2008)22 Janakiramaiah et al (2000)23 and Sharma et al (2006).24 These reports were predicted that yoga was more prominent to reduce some psychological problems.

Previous findings reported that various features of physical health such as fatigue, pain, work capacity sleep and activities of daily life improved by integrated yoga.25, 26 There was an improvement seen in the psychological domain27

Social health problems such as interpersonal relationships and social support are the most important causes of depression and anxiety.24, 28, 29

Several environmental related problems such as pollution, financial resources were cured by yoga. Yoga (Bhagavad Gita) says that yoga results in equanimity and balance (Samatvam) that can help in better tolerance to environmental changes (Sheetaushnasamah – tolerance to heat and cold).30, 31, 32

Conclusion

Finally, we concluded that Yoga has positive effect on decreasing depression and improving the quality of life among volunteers attending the yoga center. In the present scenario of increasing stress in the people despite the advances in health technologies, simple but planned Yoga intervention by psychiatrists has a significant scope in reducing depression.

Acknowledgment

The author would like thank to the Dept of Psychiatry, SMC and yoga center for providing all the necessary facilities to carry out the study.

Source of funding

None.

Conflict of Interest

None.

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