Use of yoga in acute mental health inpatient settings: A systematic review

IF 2.3 3区医学 Q2 PSYCHIATRY

Mental Health and Physical Activity Pub Date : 2025-01-21 DOI:10.1016/j.mhpa.2024.100666

Chaston Wu , Jana Waldmann , Jacqueline McPherson , Nicole Korman , Stephen Parker

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引用次数: 0

Abstract

Background

People with mental disorders accessing acute psychiatric inpatient care experience high levels of distress and acute symptoms. Yoga has been proposed as an intervention to support health and wellbeing in this context. This study aimed to synthesize the literature considering the effectiveness (including psychiatric, physical health, and service-level outcomes) and implementation (including participant experience, feasibility and safety data) of yoga in acute psychiatric inpatient settings.

Methods

We conducted a systematic review by searching Medline, CINAHL, PsycINFO, Embase, Clinicaltrials.gov, and PubMed Central as of April 2023. Any study presenting relevant empirical data was included. The population focus was people any age recruited in an inpatient psychiatric setting regardless of the primary psychiatric diagnosis, except for primary diagnoses of drug and alcohol disorders. Studies not focused on yoga as primary intervention, or not delivered in an inpatient psychiatric setting were excluded. No specific comparator or outcome focus was defined a priori. Quality appraisal was completed using the Cochrane Risk of Bias tool and Joanna Briggs Institute (JBI) checklists. Due to study heterogeneity, it was not appropriate to conduct a meta-analysis and a narrative synthesis was completed.

Results

15 studies (n = 2016) met the inclusion criteria, including four Randomised Controlled Trials (RCTs), seven pre/post studies, and four qualitative studies. Six studies had a comparison group, with three of them comparing against treatment as usual and three comparing against alternative interventions. Based on the limited available data, yoga appears to be feasible and acceptable in inpatient psychiatric settings. The main findings were subjective improvements in anxiety and positive participant experiences (relaxation; increased awareness of mind and body; feelings of connectedness with others; and spiritual wellbeing). One RCT found improvements in physical health, global functioning, and quality of life, which were sustained post-discharge. There were mixed results considering depressive and psychotic symptoms, as well as biological markers of stress. No study examined service-related implementation outcomes.

Conclusion

There is a limited evidence base for yoga conducted in inpatient mental health settings. The available evidence suggests that yoga is feasible and acceptable, without significant adverse events, with preliminary findings for anxiety reduction and positive qualitative experiences. Further research is required to determine the effectiveness on mental and physical health outcomes and what effect yoga program components have on outcomes (i.e., type, duration). Future research should also investigate the impact on service-related outcomes, such as length of stay and cost.

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瑜伽在急性精神健康住院病人中的应用：一项系统综述

精神障碍患者在接受急性精神科住院治疗时会经历高度的痛苦和急性症状。在这种情况下，瑜伽被提议作为一种支持健康和幸福的干预手段。本研究旨在综合考虑瑜伽在急性精神病住院患者中的有效性（包括精神病学、身体健康和服务水平结果）和实施（包括参与者体验、可行性和安全性数据）的文献。方法通过检索截至2023年4月的Medline、CINAHL、PsycINFO、Embase、Clinicaltrials.gov和PubMed Central进行系统综述。任何提出相关实证数据的研究都被纳入。人口重点是在精神病住院环境中招募的任何年龄的人，而不考虑初级精神病诊断，除了药物和酒精障碍的初级诊断。没有将瑜伽作为主要干预措施的研究，或者没有在住院精神病患者中进行的研究被排除在外。没有先验地定义特定的比较物或结果焦点。使用Cochrane偏倚风险工具和Joanna Briggs Institute （JBI）检查表完成质量评估。由于研究异质性，不宜进行meta分析，完成叙事综合。结果15项研究（n = 2016）符合纳入标准，包括4项随机对照试验（RCTs）、7项前后研究和4项定性研究。六项研究有一个对照组，其中三项与常规治疗进行比较，三项与替代干预进行比较。基于有限的可用数据，瑜伽在住院精神病患者中似乎是可行和可接受的。主要发现是焦虑和积极的参与者体验(放松；提高对身心的意识；与他人联系的感觉；精神健康)。一项随机对照试验发现身体健康、整体功能和生活质量的改善，这些改善在出院后持续存在。考虑到抑郁和精神病症状，以及压力的生物标记，结果好坏参半。没有研究检查与服务相关的实施结果。结论在精神卫生住院病人中进行瑜伽的证据基础有限。现有证据表明，瑜伽是可行和可接受的，没有明显的不良事件，初步发现可以减少焦虑和积极的定性体验。需要进一步的研究来确定对心理和身体健康结果的有效性，以及瑜伽项目的组成部分对结果的影响（即，类型，持续时间）。未来的研究还应调查对服务相关结果的影响，如住院时间和费用。

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来源期刊

Mental Health and Physical Activity PSYCHIATRY-

CiteScore

6.70

自引率

6.40%

发文量

审稿时长

32 days

期刊介绍： The aims of Mental Health and Physical Activity will be: (1) to foster the inter-disciplinary development and understanding of the mental health and physical activity field; (2) to develop research designs and methods to advance our understanding; (3) to promote the publication of high quality research on the effects of physical activity (interventions and a single session) on a wide range of dimensions of mental health and psychological well-being (eg, depression, anxiety and stress responses, mood, cognitive functioning and neurological disorders, such as dementia, self-esteem and related constructs, psychological aspects of quality of life among people with physical and mental illness, sleep, addictive disorders, eating disorders), from both efficacy and effectiveness trials;