TY - JOUR
T1 - Yoga for anxiety: a systematic review and meta-analysis of randomized controlled trials
AU - Cramer, Holger
AU - Lauche, Romy
AU - Anheyer, Dennis
AU - Pilkington, Karen
AU - de Manincor, Michael
AU - Dobos, Gustav
AU - Ward, Lesley
PY - 2018/4/26
Y1 - 2018/4/26
N2 - 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, 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=0.008); and large effects compared to active comparators (SMD=-0.86; 95%CI=-1.56,-0.15; P=0.02). Small effects on depression were found compared to no treatment (SMD=-0.35; 95%CI=-0.66,-0.04; P=0.03). Effects were robust against potential methodological bias. No effects were found for patients with DSM-diagnosed anxiety disorders, only for patients diagnosed by other methods and for individuals with elevated levels of anxiety without a formal diagnosis. Only 3 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.
AB - 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, 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=0.008); and large effects compared to active comparators (SMD=-0.86; 95%CI=-1.56,-0.15; P=0.02). Small effects on depression were found compared to no treatment (SMD=-0.35; 95%CI=-0.66,-0.04; P=0.03). Effects were robust against potential methodological bias. No effects were found for patients with DSM-diagnosed anxiety disorders, only for patients diagnosed by other methods and for individuals with elevated levels of anxiety without a formal diagnosis. Only 3 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.
UR - https://onlinelibrary.wiley.com/toc/15206394/0/0
U2 - 10.1002/da.22762
DO - 10.1002/da.22762
M3 - Article
SN - 1091-4269
JO - Depression and Anxiety
JF - Depression and Anxiety
ER -