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Adjunctive cognitive remediation for schizophrenia using yoga: an open, non-randomised trial

Published online by Cambridge University Press:  24 June 2014

Triptish Bhatia ,
Akhilesh Agarwal ,
Gyandeepak Shah ,
Joel Wood ,
Jan Richard ,
Raquel E. Gur ,
Ruben C. Gur ,
Vishwajit L. Nimgaonkar ,
Sati Mazumdar  and
Smita N. Deshpande
Triptish Bhatia*
Affiliation:
Training Program for Psychiatric Genetics in India, Post-graduate Institute for Medical Education and Research, Dr Ram Manohar Lohia Hospital, Delhi, India
Akhilesh Agarwal
Affiliation:
Yoga and Major Mental Illness, Department of Psychiatry, PGIMER-Dr RMLH, Delhi, India
Gyandeepak Shah
Affiliation:
Yoga and Major Mental Illness, Department of Psychiatry, PGIMER-Dr RMLH, Delhi, India
Joel Wood
Affiliation:
Biostatistics and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
Jan Richard
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Raquel E. Gur
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Ruben C. Gur
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Vishwajit L. Nimgaonkar
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
Sati Mazumdar
Affiliation:
Biostatistics and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
Smita N. Deshpande
Affiliation:
Post-graduate Institute for Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi, India
*
Triptish Bhatia, Training Program for Psychiatric Genetics in India, Post-graduate Institute for Medical Education and Research, Dr Ram Manohar Lohia Hospital, Delhi, India. Tel: +91-11-23404363; Fax: +91-11-23342122; E-mail: bhatiatriptish@yahoo.co.in
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Extract

Background: Yoga therapy (YT) improves cognitive function in healthy individuals, but its impact on cognitive function among persons with schizophrenia (SZ) has not been investigated.

Objective: To evaluate the adjunctive YT for cognitive domains impaired in SZ.

Methods: Patients with SZ received YT or treatment as usual (TAU; n = 65, n = 23, respectively). Accuracy and speed for seven cognitive domains were assessed using a computerised neurocognitive battery (CNB), thus minimising observer bias. Separately, YT was evaluated among patients with bipolar I disorder (n = 40), major depressive disorder (n = 37) and cardiology outpatients (n = 68). All patients also received routine pharmacotherapy. Patients were not randomised to YT or TAU.

Results: In comparison with the SZ/TAU group, the SZ/YT group showed significantly greater improvement with regard to measures of attention following corrections for multiple comparisons; the changes were more prominent among the men. In the other diagnostic groups, differing patterns of improvements were noted with small-to-medium effect sizes.

Conclusions: Our initial analyses suggest nominally significant improvement in cognitive function in SZ with adjunctive therapies such as YT. The magnitude of the change varies by cognitive domain and may also vary by diagnostic group.

Keywords

cognitionschizophreniayoga
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 2 , April 2012 , pp. 91 - 100
Copyright
Copyright © Cambridge University Press 2011

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References

References

1.Heinrichs, RW, Zakzanis, KK.Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 1998;12:426–445.CrossRefGoogle ScholarPubMed
2.Marazziti, D, Consoli, G, Picchetti, M, Carlini, M, Faravelli, L.Cognitive impairment in major depression. Eur J Pharmacol 2010;626:83–86.CrossRefGoogle ScholarPubMed
3.Goldberg, JF, Chengappa, KN.Identifying and treating cognitive impairment in bipolar disorder. Bipolar Disord 2009;11(Suppl. 2):123–137.CrossRefGoogle ScholarPubMed
4.Green, MF.What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996;153:321–330.Google ScholarPubMed
5.Penn, DL, Spaulding, W, Reed, D, Sullivan, M, Mueser, KT, Hope, DA.Cognition and social functioning in schizophrenia. Psychiatry 1997;60:281–291.CrossRefGoogle ScholarPubMed
6.Green, MF.Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. J Clin Psychiatry 2006;67:e12.CrossRefGoogle ScholarPubMed
7.McGurk, SR, Mueser, KT.Cognitive functioning and employment in severe mental illness. J Nerv Ment Dis 2003;191:789–798.CrossRefGoogle ScholarPubMed
8.Bourgeois, M, Swendsen, J, Young, F et al. Awareness of disorder and suicide risk in the treatment of schizophrenia: results of the international suicide prevention trial. Am J Psychiatry 2004;161:1494–1496.CrossRefGoogle ScholarPubMed
9.Rund, BR, Borg, NE.Cognitive deficits and cognitive training in schizophrenic patients: a review. Acta Psychiatr Scand 1999;100:85–95.CrossRefGoogle ScholarPubMed
10.Wykes, T, Reeder, C, Landau, S et al. Cognitive remediation therapy in schizophrenia: randomised controlled trial. Br J Psychiatry 2007;190:421–427.CrossRefGoogle ScholarPubMed
11.Hodge, MA, Siciliano, D, Withey, P et al. A randomized controlled trial of cognitive remediation in schizophrenia. Schizophr Bull 2008;36:419–427.CrossRefGoogle ScholarPubMed
12.McGurk, SR, Twamley, EW, Sitzer, DI, McHugo, GJ, Mueser, KT.A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007;164:1791–1802.CrossRefGoogle ScholarPubMed
13.SAMHSA. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration, 2006.Google Scholar
14.Raju, PS, Prasad, KV, Venkata, RY, Murthy, KJ, Reddy, MV.Influence of intensive yoga training on physiological changes in 6 adult women: a case report. J Altern Complement Med 1997;3:291–295.CrossRefGoogle ScholarPubMed
15.Sageman, S.Breaking through the despair: spiritually oriented group therapy as a means of healing women with severe mental illness. J Am Acad Psychoanal Dyn Psychiatry 2004;32:125–141.CrossRefGoogle ScholarPubMed
16.Chattha, R, Nagarathna, R, Padmalatha, V, Nagendra, HR.Effect of yoga on cognitive functions in climacteric syndrome: a randomised control study. BJOG 2008;115:991–1000.CrossRefGoogle ScholarPubMed
17.Uma, K, Nagendra, HR, Nagarathna, R, Vaidehi, S, Seethalakshmi, R.The integrated approach of yoga: a therapeutic tool for mentally retarded children: a one-year controlled study. J Ment Defic Res 1989;33(Pt 5):415–421.Google Scholar
18.Vani, PR, Nagarathna, R, Nagendra, HR, Telles, S.Progressive increase in critical flicker fusion frequency following yoga training. Indian J Physiol Pharmacol 1997;41:71–74.Google ScholarPubMed
19.Manjunath, NK, Telles, S.Improved performance in the Tower of London test following yoga. Indian J Physiol Pharmacol 2001;45:351–354.Google ScholarPubMed
20.Subramanya, P, Telles, S.Effect of two yoga-based relaxation techniques on memory scores and state anxiety. Biopsychosoc Med 2009;3:8.CrossRefGoogle ScholarPubMed
21.Brown, DP, Forte, M, Dysart, M.Visual sensitivity and mindfulness meditation. Percept Mot Skills 1984;58:775–777.CrossRefGoogle ScholarPubMed
22.Duraiswamy, G, Thirthalli, J, Nagendra, HR, Gangadhar, BN.Yoga therapy as an add-on treatment in the management of patients with schizophrenia – a randomized controlled trial. Acta Psychiatr Scand 2007;116:226–232.CrossRefGoogle ScholarPubMed
23.Behere, RV, Arasappa, R, Jagannathan, A et al. Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatr Scand 2011;123:147–153.CrossRefGoogle ScholarPubMed
24.Selvamurthy, W, Nayar, H, Joseph, S.Physiological effects of yogic practice. NIMHANS J 1983;1:71–80.Google Scholar
25.Wallace, RK, Benson, H, Wilson, AF.A wakeful hypometabolic physiologic state. Am J Physiol 1971;221:795–799.CrossRefGoogle ScholarPubMed
26.Joseph, S, Sridharan, K, Patil, SK et al. Study of some physiological and biochemical parameters in subjects undergoing yogic training. Indian J Med Res 1981;74:120–124.Google ScholarPubMed
27.Steptoe, A, Kearsley, N, Walters, N.Cardiovascular activity during mental stress following vigorous exercise in sportsmen and inactive men. Psychophysiology 1993;30: 245–252.CrossRefGoogle ScholarPubMed
28.Nurnberger, JI Jr, Blehar, MC, Kaufmann, CA et al. Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 1994;51:849–859. Discussion 863–864.CrossRefGoogle ScholarPubMed
29.Deshpande, SN, Mathur, MN, Das, SK, Bhatia, T, Sharma, S, Nimgaonkar, VL.A Hindi version of the diagnostic interview for genetic studies. Schizophr Bull 1998;24:489–493.CrossRefGoogle ScholarPubMed
30.Maxwell, E.Family interview for genetic studies (FIGS). Intramural Research Program – clinical neurogenetics branch. Rockville: National Institute of Mental Health, 1992.Google Scholar
31.Gur, RC, Ragland, JD, Moberg, PJ et al. Computerized neurocognitive scanning: II. The profile of schizophrenia. Neuropsychopharmacology 2001;25:777–788.CrossRefGoogle ScholarPubMed
32.Sachs, G, Steger-Wuchse, D, Kryspin-Exner, I, Gur, RC, Katschnig, H.Facial recognition deficits and cognition in schizophrenia. Schizophr Res 2004;68:27–35.CrossRefGoogle ScholarPubMed
33.Gur, RE, Nimgaonkar, VL, Almasy, L et al. Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. Am J Psychiatry 2007;164:813–819.CrossRefGoogle Scholar
34.Avila, R, Bottino, CM, Carvalho, IA, Santos, CB, Seral, C, Miotto, EC.Neuropsychological rehabilitation of memory deficits and activities of daily living in patients with Alzheimer's disease: a pilot study. Braz J Med Biol Res 2004;37:1721–1729.CrossRefGoogle ScholarPubMed
35.Cohen, J.Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum, 1976.Google Scholar
36.Hochberg, A.Sharper Bonferroni procedure for multiple tests of significance. Biometrika 1988;75:800–802.CrossRefGoogle Scholar
37.Nielsen, BM, Mehlsen, J, Behnke, K.Altered balance in the autonomic nervous system in schizophrenic patients. Clin Physiol 1988;8:193–199.CrossRefGoogle ScholarPubMed

Supporting Information

The following Supporting information is available for this article:

Table S1. Effect sizes of changes in pre- and post-therapy values for cognitive domains in the schizophrenia yoga therapy (21 days) and treatment as usual groups (2 months)

Table S2. Effect sizes of changes in pre- and post-therapy values for cognitive domains in the bipolar disorder yoga therapy

Table S3. Effect sizes of changes in pre- and post-therapy values for cognitive domains in the major depressive disorder yoga therapy

Table S4. Effect sizes of changes in pre- and post-therapy values for cognitive domains in the cardiac controls yoga therapy

Table S5. Effect sizes of changes in pre- and post-therapy values for cognitive domains in the schizophrenia yoga therapy (2 months) and treatment as usual groups (2 months)

Additional Supporting information may be found in the online version of this article.

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