Exploring the effect of yoga on depression and anxiety in people with cancer : a mixed methods investigation

Abstract

Cancer is a leading cause of morbidity and mortality. A diagnosis of cancer can affect a person's physical, psychological, spiritual, and social well-being. The unique psychosocial concerns (e.g. depression and anxiety) faced by people with cancer can have a significant impact on wellbeing, quality of life and survival, and are often under-detected and under-treated. Current treatments for anxiety and depression encompass pharmacological and psychological interventions. However, questions related to efficacy, side effects, cost effectiveness, individual choice, suitability for different people, barriers and access to services, compliance, ethics and long-term benefits, are common. This together with the significant health impacts of the disorders, constitutes a compelling case for finding safe and effective treatments for anxiety and depression in people with cancer. There is increasing interest in the potential role of integrative interventions, including yoga, for a range of health concerns, including mental health. The popularity of yoga is increasing across the world and is an appealing choice for many people as it has low rates of adverse events and can be used in conjunction with other treatments without concerns of interaction effects. Moreover, positive impacts on depression and anxiety symptoms in people without comorbid conditions as well as those with cancer have been demonstrated. This project was designed to review the current literature in the field, then develop and evaluate the effects of a yoga program on the mental health of people with cancer. The effects of yoga interventions on self-reported depression and anxiety symptoms in people with cancer was investigated via a systematic review and meta-analysis of 26 clinical trials. Results revealed evidence for significant medium effects of yoga for reducing depression (N = 1,486, g = -0.419, 95% CI -0.558 to -0.281, p < 0.001) and anxiety (N = 977, g = -0.347, 95% CI -0.473 to -0.221, p < 0.001) symptoms compared to controls. Subgroup analyses for depressive symptoms revealed significant effects for all analyses performed (type of cancer, type of control, treatment status, duration of intervention or frequency of yoga sessions), with effect sizes being comparable between subgroups. Similar findings were found for anxiety symptoms except for treatment status, where the only significant effect was found when yoga was delivered during active treatment. Thus, this review provided evidence that in people with cancer, yoga-based interventions are associated with amelioration of depression and anxiety symptoms and therefore a promising therapeutic modality for their management.

Date of Award	2022
Original language	English