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| RESEARCH ARTICLE |
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| Year : 2017 | Volume
: 14
| Issue : 1 | Page : 17-19 |
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Effectiveness of yoga therapy on self perception of health among the inpatients with schizophrenia
NV Asha Vijayan
Staff nurse, NIMHANS, Bangalore, India
| Date of Web Publication | 9-Jul-2019 |
Correspondence Address:
N V Asha Vijayan
Staff nurse, NIMHANS, Bangalore
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/2231-1505.262415
Schizophrenia is among the most severe psychiatric disorders. Yoga as an adjuvant therapy has shown improvement in self awareness, stress reduction, creation of energy and also as a best complementary treatment for schizophrenia. Assessment of self perception of health indicates beneficial impact in improving positive and negative symptoms and enhancing health-related quality of life of patient with schizophrenia. The aim of the present study was to evaluate the effect of yoga on self perception of health in patients with schizophrenia. Patients with schizophrenia were randomly allotted to either Yoga with conventional care (Y) (n=25) or conventional care (Cc) (n=25) groups. Those in the yoga group were taught a specific yoga module with asanas and pranayama. Pre and post assessment done with visual analogous scale (VAS) and patient health questionnaire (PHQ). Result shown that improved self perception of health in both groups but statistically improved in yoga group (Y) group than the conventional care (CC) VAS score have statistically significant improvement (p<0.001) and PHQ score shows statistically significant improvement in yoga with conventional care groups.
Keywords: schizophrenia, yoga, self perception of health
How to cite this article:
Asha Vijayan N V. Effectiveness of yoga therapy on self perception of health among the inpatients with schizophrenia. Indian J Psy Nsg 2017;14:17-9 |
How to cite this URL:
Asha Vijayan N V. Effectiveness of yoga therapy on self perception of health among the inpatients with schizophrenia. Indian J Psy Nsg [serial online] 2017 [cited 2023 Jun 1];14:17-9. Available from: https://www.ijpn.in/text.asp?2017/14/1/17/262415 |
| Introduction | |  |
Schizophrenia is a relatively common mental disorder with a lifetime prevalence of 0.3% to 0.6% and an incidence of 10.2 to 22 per 100,000[1] Schizophrenia has been identified as a serious public health concern, ranking 11th in the causes of years lived with disability worldwide. Schizophrenia has many different clinical presentations, with patients suffering both positive and negative symptoms. Positive symptoms reflect an excess or distortion of normal functions such as delusions, hallucinations, and disorganised speech and behaviour. Negative symptoms reflect a reduction or loss of normal functions such as affective flattening, apathy, avolition, and social withdrawal. The pathophysiology of the manifestation of negative symptoms is not yet fully understood, while positive symptoms are thought to be due to mesolimbic dopaminergic overactivity[2],[3],[4],[5] The various symptoms of schizophrenia can have a significant impact on a person’s ability to function within society.
Yoga has demonstrated success in improving cognition, has improved obesity as well as metabolic syndrome, helped in correcting menstrual disturbances and some other endocrine dysfunctions. It is in this context, a role for yoga has been conceived in the treatment of schizophrenia after medications produce their effects[3]. Studies assessing the effectiveness of yoga as a complimentary treatment showed a beneficial impact in improving positive and negative symptoms and enhancing health-related quality of life of schizophrenic patients[1].Schizophrenic patients showed great improvement in symptoms and a decrease in negative thoughts. Yoga therapy also improves quality of life and is proven as a beneficial adjunctive treatment for those suffering from schizophrenia[3].
Yoga is reported to have significant benefits in increasing the body awareness and achievement of state of self-realization. This helps the schizophrenic patient to distinguish the reality from delusion, hallucination and negative thoughts.
| Material and Methods | | |
The present study was approved by the institutional Ethical committee. Fifty subjects were recruited from a tertiary psychiatric hospital. Both male and female patient with schizophrenia between the age group of 15-60 years satisfying the criteria were recruited for the study. Patients were randomized to conventional care only (Cc) and conventional care and yoga therapy(Y) using a concealed allocation protocol. Group Cc- subjects received conventional care. Group Y- subjects received conventional care along with yoga intervention only. The yoga intervention consisted daily practice of loosening exercise, breathing exercise, asanas or postures done with awareness and shavasana. Each session lasted for 45 minutes to one hour yoga therapy was imparted by trained yoga therapist at the yoga centre in the institution premises. Daily record of attendance and compliance of yoga intervention were maintained. Self health assessment were done pre-test and at the end of 12 session of intervention in both group. Assessment done by PHQ (patient health questionnaire) and VAS (visual analogue scale)
The visual analogue scale was a ten centimetre long line marked from 0-10, at an interval of one centimetre each zero indicated no anger and 10 indicated the maximum amount of anger experienced (aiteken1969). The total score of PHQ was calculated for classifying the level of health. Total score is 25 and is categorized as score >5- mild depression and >20 - severe depression. Descriptive statistical analysis has been carried out in the present study. Results on continuous measurements were presented on Mean ± SD unpaired t-test was used to compare the variables at the baseline characteristics of the two groups of patients. Paired t-test was used to compare the effectiveness following 12 sessions of intervention.
| Result | | |
A total of 25 subjects with schizophrenia were studied under conventional care (Group CC) and 25 were studied under Yoga with conventional care (Group Y) group. Both the study groups were identical in demographic variables such as age, gender distribution and mean duration of the illness as given in [Table 1]. | Table 1: Distribution of subjects based on socio demographic variable (n=50)
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 | Table 2: Effect of treatment on clinical variables of Patients (self perception of health by VAS and PHQ Score)
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For subjects in Group 1 the Yoga with conventional care group; Group 2 the conventional care group; values expressed as Mean±SEM; *p<0.05, **p<0.01, ***p<0.001 Pre test vs. Post test within group comparison; p<0.05 Group 1 vs Group 2 at baseline; p<0.001 Group 1 vs Group 2 after 12 session of yoga/ conventional care.
Self health assessment of Subjects on VAS score as shown in [Figure: 1] in group Y depicts that the score was increased from 5.00± 0.31 to 7.308 ±0. In group Cc the subjects visual analogue scale increased from 44.54± 0.38 to 4.67±0.31. VAS scores were increased in both groups but statistically improved in group Y ( yoga) than the group Cc(conventional care ). Yoga with conventional care groups have shown significant improvement (p<0.001). | Figure 1: Effect of treatment on clinical variables of Patients (self perception of health by VAS Score)
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Self health assessment of Subjects on PHQ score as shown in [Figure 2] in group Y depicts that the score decreased from 19.44±76 to 12.12±1.057 and in group Cc the subjects, the PHQ score increased from 20.16±.745 to22.32±3.051.PHQ scores were decreased in group Y groups shows the level of depression decreased from moderately severe to moderate depression, whereas in group Cc the level of depression increased to severe depression. There was a statistically significant improvement in group Y( yoga) group than the group Cc. Yoga with conventional care groups have shown significant improvement (p<0.001.) | Figure 2: Effect of treatment on clinical variables of Patients (self perception of health by PHQ Score)
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| Discussion | | |
As a part of the present study pre- test assessment statistically proved that the study subjects had only moderate level of self perception of health and moderately severe level of depression. A total of twelve session of planned yoga intervention given to group Y group along with treatment and conventional care as usual. Yoga interventions were not given to group Cc but they received treatment and conventional care as usual .At the completion of last session, a post-test was carried by re-administering VAS and PHQ scale.
In group Y group the subject’s visual analogue scale score was increased from 5.00± 0.31 to 7.308 ±0. In group Cc the subject’s visual analogue scale increased from 44.54± 0.38 to 4.67±0.31. VAS scores were increased in both groups but statistically improved in group Y (yoga) group than the control group. Yoga with conventional care groups have shown significant improvement (p<0.001).
In group Y the subjects the PHQ score was decreased from 19.44±76 to 12.12±1.057 and ,in group Cc , the PHQ score increased from 20.16±.745 to22.32±3.051.PHQ scores were decreased in group Y groups shows the level of depression decreased from moderately severe to moderate depression , whereas in group Cc the level of depression increased to severe depression. There was statistically significant improvement in group Y (yoga) group than the control group. Yoga with conventional care groups have shown significant improvement (p<0.001).
Present study findings were also compared with the study conducted by Shuba et al et al conducted a study on the perception of patients with psychiatric disorders regarding the effects of yoga on their health. There was a significant improvement in overall health in terms of Visual Analogue Scale in Repeated Measures Analysis of Variance for within group variation (p<0.01).The difference was significant between all time lines (third, seventh & tenth session VAS score) The majority (90%) of patients reported positive change after two weeks (10 sessions) of add-on yoga therapy. The perceived positive changes by the patients were both physical and mental. 78% of the patients reported that their expectations were met at the end of two weeks of adjunct yoga therapy and 70% of the patients reported that they don’t expect any difficulties in continuing the practice at home.
| Conclusion | | |
Present study showed that the level of self perception of health increased and level of depression decreased in group Y group than the group Cc after the implementation of yoga intervention. However, Yoga with conventional care group showed better results when compared to the conventional care group. Hence, Yoga therapy can be used as add on therapy in self perception of patient with schizophrenia.
| References | | |
| 1. | Gangadhar BN, Varambally S. Yoga as therapy in psychiatric disorders: Past, present, and future. Biofeedback 2011; 39:60 3.  |
| 2. | Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E,et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSMIV and ICD10. J Clin Psychiatry 1998; 59 Suppl 20:22, 33. |
| 3. | Vancampfort D, De Hert M, Knapen J, Wampers M, Demunter H, Deckx S, et al. State anxiety, psychological stress and positive well being responses to yoga and aerobic exercise in people with schizophrenia: A pilot study. Disabil Rehabil 2011; 33:684 9. |
| 4. | Varambally S, Gangadhar BN, Thirthalli J, Jagannathan A, Kumar S, Venkatasubramanian G, et al. Therapeutic efficacy of add on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlist. Indian J Psychiatry 2012; 54:227 32. |
| 5. | Field T. Yoga clinical research review. Complement Ther Clin Pract2011; 17:1, 8. |
[Figure 1], [Figure 2]
[Table 1], [Table 2]
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