Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials

Cramer, H; Lauche, R; Anheyer, D; Pilkington, K; de Manincor, M; Dobos, G; Ward, L

Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials

Cramer, H

Lauche, R

Anheyer, D Pilkington, K de Manincor, M Dobos, G Ward, L

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Publication Type:: Journal Article
Citation:: Depression and Anxiety, 2018, 35 (9), pp. 830 - 843
Issue Date:: 2018-09-01

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Field	Value	Language
dc.contributor.author	Cramer, H https://orcid.org/0000-0002-3640-8046	en_US
dc.contributor.author	Lauche, R https://orcid.org/0000-0002-4171-7935	en_US
dc.contributor.author	Anheyer, D	en_US
dc.contributor.author	Pilkington, K	en_US
dc.contributor.author	de Manincor, M	en_US
dc.contributor.author	Dobos, G	en_US
dc.contributor.author	Ward, L https://orcid.org/0000-0001-7285-2032	en_US
dc.date.available	2020-05-25T19:10:49Z
dc.date.issued	2018-09-01	en_US
dc.identifier.citation	Depression and Anxiety, 2018, 35 (9), pp. 830 - 843	en_US
dc.identifier.issn	1091-4269	en_US
dc.identifier.uri	http://hdl.handle.net/10453/123082
dc.description.abstract	© 2018 Wiley Periodicals, Inc. Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0–38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = −0.43; 95% confidence interval [CI] = −0.74, −0.11; P =.008), and large effects compared to active comparators (SMD = −0.86; 95% CI = −1.56, −0.15; P =.02). Small effects on depression were found compared to no treatment (SMD = −0.35; 95% CI = −0.66, −0.04; P =.03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.	en_US
dc.relation.ispartof	Depression and Anxiety	en_US
dc.relation.isbasedon	10.1002/da.22762	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Yoga	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Anxiety Disorders	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Randomized Controlled Trials as Topic	en_US
dc.title	Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	35	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1701 Psychology	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	35	en_US

Abstract:

© 2018 Wiley Periodicals, Inc. Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0–38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = −0.43; 95% confidence interval [CI] = −0.74, −0.11; P =.008), and large effects compared to active comparators (SMD = −0.86; 95% CI = −1.56, −0.15; P =.02). Small effects on depression were found compared to no treatment (SMD = −0.35; 95% CI = −0.66, −0.04; P =.03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.

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http://hdl.handle.net/10453/123082