Hamilton-West Kate, Pellatt-Higgins Tracy, Sharief Farnaaz
Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK.
NHS Medway Clinical Commissioning Group, Manage Your Mind, Chatham, UK.
Prim Health Care Res Dev. 2019 Jun 20;20:e73. doi: 10.1017/S1463423619000045.
Research identifies a need for expanded therapeutic options for people with mild-to-moderate depression and anxiety disorders treated within the UK National Health Service (NHS). We aimed to examine potential benefits of a Sudarshan Kriya Yoga (SKY) based breath intervention delivered in this context.
SKY is a structured programme derived from yoga in which participants are taught relaxation and stress-management techniques including body postures, breathing exercises and cognitive-behavioural procedures. Previous research has demonstrated benefits for patients with clinical and non-clinical depression and anxiety. However, SKY has not yet been evaluated as a therapeutic option for patients accessing NHS primary care mental health services.
We evaluated an existing programme available to NHS patients in South East England. The intervention is community-based and delivered via four weekly 'stress buster sessions' (1-h duration), one weekend intensive workshop (2.5 days) and four weekly (90 min) follow-up sessions. Analyses were conducted on existing data [measures of depression (Patient Health Questionnaire-9) and anxiety (generalised anxiety disorder-7)] collected as part of routine care, at the start of the programme and three follow-up assessments.
Baseline data were available for 991 participants, of which 557 (56.2%) attended at least three weekly workshops, 216 (21.8%) attended the weekend workshop and 169 (17.1%) completed the programme. Statistically significant (P<0.05) improvements in depression and anxiety were observed in all three outcome assessments. Clinically meaningful change was observed for 74.6% of participants completing the programme. Findings indicate that SKY has the potential to benefit patient outcomes and could be offered more widely as a therapeutic option. We recommend further research to explore patients' experiences of the programme, determine the number of sessions necessary for improvement/ recovery, define the population most likely to respond and examine potential cost savings (e.g., reductions in antidepressant prescribing/referrals to secondary care).
研究表明，对于在英国国家医疗服务体系（NHS）接受治疗的轻至中度抑郁症和焦虑症患者，需要更多的治疗选择。我们旨在研究在这种情况下实施的基于苏达山克里亚瑜伽（SKY）的呼吸干预的潜在益处。
SKY是一项源自瑜伽的结构化课程，参与者会学习放松和压力管理技巧，包括身体姿势、呼吸练习和认知行为程序。先前的研究已证明该课程对临床和非临床抑郁症及焦虑症患者有益。然而，SKY尚未被评估为NHS初级保健心理健康服务患者的一种治疗选择。
我们评估了英格兰东南部NHS患者可参与的一个现有项目。该干预基于社区，通过四周一次的“压力消除课程”（每次1小时）、一个周末强化工作坊（2.5天）以及四周一次（每次90分钟）的后续课程来实施。分析使用了作为常规护理一部分收集的现有数据[抑郁症（患者健康问卷-9）和焦虑症（广泛性焦虑障碍-7）的测量数据]，这些数据在项目开始时以及三次随访评估时收集。
991名参与者有基线数据，其中557人（56.2%）参加了至少三次每周的工作坊，216人（21.8%）参加了周末工作坊，169人（17.1%）完成了该项目。在所有三次结果评估中，抑郁症和焦虑症均有统计学显著改善（P<0.05）。完成该项目的参与者中有74.6%观察到了具有临床意义的变化。研究结果表明，SKY有可能改善患者的治疗效果，并可作为一种治疗选择更广泛地提供。我们建议进行进一步研究，以探索患者对该项目的体验，确定改善/康复所需的课程次数，确定最可能有反应的人群，并研究潜在的成本节约（例如，减少抗抑郁药处方/转介至二级护理）。
