Mindfulness, Yoga and Other Non-Pharmacologic Therapies for Mental Health

Below I have provided a selection of well performed, practical. and relevant research that made its way onto my computer screen and into my mind over the past few months! I have tried to distill down some of the major ideas from the studies into bite-sized summaries and conclusions, citing and drawing from some of the author’s comments as well. Links are provided for your exploration! I hope you find this helpful and and can share some of this research with colleagues, friends, and patients.

1. Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomized controlled trials.

Summary
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Mindfulness-based interventions (MBIs) were shown to decrease the likelihood for relapse in those diagnosed with an acute episode of depression. Additionally MBIs have been shown to be effective for the reduction of symptom severity during an acute depressive episode.
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“Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population.”

http://www.ncbi.nlm.nih.gov/pubmed/24763812


2. Individualized Yoga for Reducing Depression and Anxiety, and Improved Well Being: A Randomized Controlled Trial.

Summary

A 6-week trial that showed improvements in resiliency and overall mental health as scored by the SF-12 mental health scale.

“Yoga plus regular care was effective in reducing symptoms of depression compared with regular care alone. Individualized yoga may be particularly beneficial in mental health care in the broader community.”

http://www.ncbi.nlm.nih.gov/pubmed/27030303


3. Life Balance - a mindfulness-based mental health promotion program: conceptualization, implementation, compliance and user satisfaction in a field setting.

Summary

This study did not report any specific results regarding the effectiveness of the program or intervention, but did show feasibility of implementing a mindfulness based program as run by laypersons (non-clinical) for individuals in the community (not targeting a specific patient population). It was done in Germany as a means of “primary prevention” attempting to prevent individuals from developing mental illness. See what Germany cares about!?! Love this concept.

“The mindfulness-based prevention program “Life Balance” is based on research on resilience and protective factors for mental health, and uses evidence-based intervention strategies from psychotherapy research to strengthen those protective factors.”

http://www.ncbi.nlm.nih.gov/pubmed/26231662

4. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies.

Summary

The study asks the question: How do mindfulness-based interventions work? What is the mechanism behind the positive (or negative) results? A very insightful article helping individuals to better answer the question of what practices to pursue and how such practices may improve their well being.

​“This review identified strong, consistent evidence for cognitive and emotional reactivity, moderate and consistent evidence for mindfulness, rumination, and worry, and preliminary but insufficient evidence for self-compassion and psychological flexibility as mechanisms underlying MBIs.”

http://www.ncbi.nlm.nih.gov/pubmed/25689576

5. A comparison of the effects of hatha yoga and resistance exercise on mental health and well-being in sedentary adults: a pilot study.

Summary

Individuals in this study participated in 3 sessions per week over 7 weeks for a total of 21 sessions of either yoga or resistance exercise. Both yoga and resistance exercise showed positive benefit compared to the control group. My take: incorporating aspects of both resistance training and yoga is likely to improve your well being across multiple domains and it is likely that combining the practices will provide added or even synergistic benefits.

"Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group. No improvements were found in the Control Group. Hatha yoga more improved the dimensions fatigue, self-esteem, and quality of life, whilst resistance exercise training more improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level.”
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http://www.ncbi.nlm.nih.gov/pubmed/24906581

6. Mindfulness-based stress reduction for healthy individuals: A meta-analysis

Summary

Studies performed on healthy population at baseline- this was a meta-analysis so it analyzed results and effects from total of 29 different studies as a collective pool of data.The meta-analysis revealed high quality evidence for MBSR type interventions to reduce stress as well as a moderate level of evidence for such interventions to improve anxiety, depression and overall quality of life. The positive effects seemed to be modulated by changes in state awareness-mindfulness and elements of compassion to self and others. The authors recognized that there were some major differences between how the individual studies examined in the meta-analysis were designed and carried out, potentially limiting their ability to make strong and relevant conclusions about any particular intervention. I see that this point, however, while potentially “negative” with regards to strict scientific methodology, reproducibility and measures of validity, as actually a good thing. To me, the meta-analysis shows that many different types of mindfulness programs have been shown and are likely to have positive effects and that there is more than one way to structure an intervention so that participants can benefit. Let’s be flexible and realize that one size does not fit all and that we don’t have to follow a cookie cutter exact template for administering a mindfulness-based intervention and can still expect to see positive improvements in most participants.

“Results suggested large effects on stress, moderate effects on anxiety, depression, distress, and quality of life, and small effects on burnout. When combined, changes in mindfulness and compassion measures correlated with changes in clinical measures at post-treatment and at follow-up. However, heterogeneity was high, probably due to differences in the study design, the implemented protocol, and the assessed outcomes.”

​http://www.ncbi.nlm.nih.gov/pubmed/25818837

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