Moosburner Alina, Cramer Holger, Bilc Mirela, Triana Johanna, Anheyer Dennis
Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany.
Robert Bosch Center for Integrative Medicine and Health, Stuttgart, Germany.
Depress Anxiety. 2024 Dec 19;2024:6071055. doi: 10.1155/da/6071055. eCollection 2024.
The prevalence of depression has been increasing sharply. Given the existing treatment gap and the high prevalence of nonresponders to conventional therapies, the potential of complementary medicine becomes clear. The effect of yoga on depression has already been studied, but its efficacy in manifest depressive disorders remains unclear. To update and evaluate the current state of evidence for yoga as a therapy option for depressive disorders. PubMed/Medline, Cochrane Library, Scopus, PsycINFO, and BASE were searched systematically. Randomized controlled trials (RCTs), including participants with depressive disorders, were eligible. Analyses were conducted for active and passive control groups separately and for subgroups of major depressive disorder (MDD) and mixed samples. The risk of bias was assessed using the Cochrane risk of bias tool 2.0. Primary outcomes were the severity of depression and remission rates, and secondary outcomes were health-related quality of life and adverse events. The quality of evidence was assessed according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Twenty-four studies ( = 1395) were included; of those, 20 studies ( = 1333) were meta-analyzed. Yoga showed a statistically significant short-term effect on depression severity when compared to passive control (standardized mean difference [SMD] = -0.43, 95% confidence interval [CI] = [-0.80; -0.07]) but not when compared to active control (SMD = -0.22, 95% CI = [-0.67; 0.23]). Regarding remission rates, statistically significant effects were observed when comparing yoga to passive (odds ratio [OR] = 3.20; 95% CI = [1.45; 7.10]) as well as to active control (OR = 2.04; 95% CI = [1.13; 3.69]). No differences on safety outcomes were observed for passive (OR = 1.00, 95% CI = [0.10; 9.98]) as well as for active control (OR = 0.80, 95% CI = [0.08; 8.09]). The quality of evidence ranged from moderate to very low. Due to the heterogeneity of outcome reporting, no meta-analysis for quality of life was possible. Yoga is an effective therapy approach for reducing depression severity when compared to passive control and obtains higher remission rates when compared to active and passive controls. Quality of evidence is inconsistent, but given the positive risk-benefit ratio of the intervention and the urge for therapy options for depression, yoga should be considered as a possible treatment option, particularly for MDD patients.
抑郁症的患病率一直在急剧上升。鉴于现有的治疗差距以及对传统疗法无反应者的高患病率，补充医学的潜力变得显而易见。瑜伽对抑郁症的影响已经得到研究，但其在明显的抑郁症中的疗效仍不明确。为了更新和评估瑜伽作为抑郁症治疗选择的现有证据状况。系统检索了PubMed/Medline、Cochrane图书馆、Scopus、PsycINFO和BASE。纳入了包括抑郁症患者的随机对照试验（RCT）。分别对主动和被动对照组以及重度抑郁症（MDD）亚组和混合样本进行了分析。使用Cochrane偏倚风险工具2.0评估偏倚风险。主要结局是抑郁严重程度和缓解率，次要结局是与健康相关的生活质量和不良事件。根据推荐分级、评估、制定和评价（GRADE）对证据质量进行评估。纳入了24项研究（n = 1395）；其中，20项研究（n = 1333）进行了荟萃分析。与被动对照相比，瑜伽对抑郁严重程度有统计学显著的短期影响（标准化均值差[SMD]= -0.43，95%置信区间[CI]=[-0.80；-0.07]），但与主动对照相比则无显著影响（SMD = -0.22，95% CI = [-0.67；0.23]）。关于缓解率，与被动对照（优势比[OR]= 3.20；95% CI = [1.45；7.10]）以及主动对照（OR = 2.04；95% CI = [1.13；3.69]）相比，观察到统计学显著影响。被动对照（OR = 1.00，95% CI = [0.10；9.98]）以及主动对照（OR = 0.80，95% CI = [0.08；8.09]）在安全性结局方面未观察到差异。证据质量从中等到非常低不等。由于结局报告的异质性，无法对生活质量进行荟萃分析。与被动对照相比，瑜伽是一种减轻抑郁严重程度的有效治疗方法，与主动和被动对照相比，其缓解率更高。证据质量不一致，但鉴于该干预措施积极的风险效益比以及对抑郁症治疗选择的迫切需求，瑜伽应被视为一种可能的治疗选择，特别是对于MDD患者。
