Sylvia Louisa G, Busch Andrew M, Rabideau Dustin J, Gold Alexandra, Danhauer Suzanne C, Schatten Heather T, Katz Douglas, Weinstock Lauren M, Dahne Jennifer, Schmid Sabine P, Soetan Zainab, Tovey Roberta, Pintro Kedie, Kvaka Adrienne, Hernandez Antonietta Alvarez, Hsu Ingrid, Melendez Alba, Adkins-Hempel Melissa, Grubb Angela, Lozado Odalys, Fili Atefeh Alavi, Chau Giuliana, Uebelacker Lisa A
Massachusetts General Hospital, Boston, Massachusetts, United States of America.
Harvard Medical School, Boston, Massachusetts, United States of America.
PLoS One. 2025 Jan 6;20(1):e0315506. doi: 10.1371/journal.pone.0315506. eCollection 2025.
Depression is a prevalent mental health condition in the United States and a significant cause of morbidity and mortality. The treatment guidelines for depression recommends either psychotherapy, such as behavioral activation (BA), or a second-generation antidepressant as a first-line treatment for adult patients with depression. However, many individuals with depression do not experience improvement from first-line treatments or choose not to engage in them due to stigma, cost, difficulty with access, and/or side effects. As such we need new treatments for depression and yoga is especially promising given recent data on its efficacy for depression. This study seeks to compare a first-line treatment for depression, or BA, versus yoga to examine whether yoga does as well as BA at improving depressive symptoms and secondary outcomes. We will also examine improvements in depressive symptoms, and secondary outcomes, by specific sub-populations to determine who might do better in which treatment (i.e., BA or yoga). Given that this is the first non-inferior, comparative effectiveness study of yoga, this paper explains the study design, the rationale for the study design, as well as lessons learned in conducting the study.
抑郁症是美国一种普遍的心理健康状况，也是发病和死亡的重要原因。抑郁症治疗指南建议，对于成年抑郁症患者，一线治疗方案可以是心理治疗，如行为激活疗法（BA），或者是第二代抗抑郁药。然而，许多抑郁症患者并未从一线治疗中得到改善，或者由于耻辱感、费用、就医困难和/或副作用而选择不接受治疗。因此，我们需要新的抑郁症治疗方法，鉴于最近有关瑜伽治疗抑郁症疗效的数据，瑜伽尤其具有前景。本研究旨在比较抑郁症的一线治疗方法——行为激活疗法（BA）和瑜伽，以检验瑜伽在改善抑郁症状和次要结果方面是否与行为激活疗法效果相当。我们还将按特定亚组研究抑郁症状和次要结果的改善情况，以确定哪种治疗方法（即行为激活疗法或瑜伽）对哪些人效果更佳。鉴于这是第一项关于瑜伽的非劣效性、比较有效性研究，本文阐述了研究设计、该研究设计的基本原理以及开展该研究过程中获得的经验教训。
