Skip to main content
    • Aa
    • Aa

Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial

  • L. A. Uebelacker (a1) (a2), G. Tremont (a2) (a3), L. T. Gillette (a4), G. Epstein-Lubow (a1) (a2), D. R. Strong (a5), A. M. Abrantes (a1) (a2), A. R. Tyrka (a1) (a2), T. Tran (a2) (a3), B. A. Gaudiano (a1) (a2) and I. W. Miller (a1) (a2)...

The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment.


We conducted a randomized controlled trial of weekly yoga classes (n = 63) v. health education classes (Healthy Living Workshop; HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning.


At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b = −0.82, s.e. = 0.88, p = 0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = −1.38, s.e. = 0.57, p = 0.02). At 6-month follow-up, 51% of yoga participants demonstrated a response (⩾50% reduction in depression symptoms) compared with 31% of HLW participants (odds ratio = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time.


Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

Corresponding author
*Address for correspondence: L. A. Uebelacker, Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

AM Abrantes , N McLaughlin , BD Greenberg , DR Strong , D Riebe , M Mancebo , S Rasmussen , J Desaulniers , RA Brown (2012). Design and rationale for a randomized controlled trial testing the efficacy of aerobic exercise for patients with obsessive–compulsive disorder. Mental Health and Physical Activity 5, 155165.

D Bates , M Maechler , BM Bolker , S Walker (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software 67, 148.

CL Bockting , SD Hollon , RB Jarrett , W Kuyken , K Dobson (2015). A lifetime approach to major depressive disorder: the contributions of psychological interventions in preventing relapse and recurrence. Clinical Psychology Review 41, 1626.

J Cohen (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates: Hillsdale, NJ.

PK Corey-Lisle , R Nash , P Stang , R Swindle (2004). Response, partial response, and nonresponse in primary care treatment of depression. Archives of Internal Medicine 164, 11971204.

H Cramer , R Lauche , H Haller , G Dobos (2013). A systematic review and meta-analysis of yoga for low back pain. Clinical Journal of Pain 29, 450460.

A Feingold (2009). Effect sizes for growth-modeling analysis for controlled clinical trials in the same metric as for classical analysis. Psychological Methods 14, 4353.

K Kroenke , RL Spitzer , JBW Williams (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606613.

AJ Rush , IH Bernstein , MH Trivedi , TJ Carmody , S Wisniewski , JC Mundt , K Shores-Wilson , MM Biggs , A Woo , AA Nierenberg , M Fava (2006 a). An evaluation of the Quick Inventory of Depressive Symptomatology and the Hamilton Rating Scale for Depression: a Sequenced Treatment Alternatives to Relieve Depression trial report. Biological Psychiatry 59, 493501.

AJ Rush , MH Trivedi , HM Ibrahim , TJ Carmody , B Arnow , DN Klein , JC Markowitz , PT Ninan , S Kornstein , R Manber , ME Thase , JH Kocsis , MB Keller (2003). The 16-item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry 54, 573583.

AJ Rush , MH Trivedi , SR Wisniewski , AA Nierenberg , JW Stewart , D Warden , G Niederehe , ME Thase , PW Lavori , BD Lebowitz , PJ McGrath , JF Rosenbaum , HA Sackeim , DJ Kupfer , J Luther , M Fava (2006 b). Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. American Journal of Psychiatry 163, 19051917.

AL Stewart , JE Ware Jr. RH Brook (1981). Advances in the measurement of functional status: construction of aggregate indexes. Medical Care 19, 473488.

LA Uebelacker , G Tremont , G Epstein-Lubow , BA Gaudiano , T Gillette , Z Kalibatseva , IW Miller (2010). Open trial of Vinyasa yoga for persistently depressed individuals: evidence of feasibility and acceptability. Behavior Modification 34, 247264.

AM van der Velden , W Kuyken , U Wattar , C Crane , KJ Pallesen , J Dahlgaard , LO Fjorback , J Piet (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review 37, 2639.

PS Wang , GE Simon , J Avorn , F Azocar , EJ Ludman , J McCulloch , MZ Petukhova , RC Kessler (2007). Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes: a randomized controlled trial. Journal of the American Medical Association 298, 14011411.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary Materials

Uebelacker supplementary material
Uebelacker supplementary material

 Word (40 KB)
40 KB


Altmetric attention score

Full text views

Total number of HTML views: 18
Total number of PDF views: 162 *
Loading metrics...

Abstract views

Total abstract views: 3242 *
Loading metrics...

* Views captured on Cambridge Core between 6th April 2017 - 21st September 2017. This data will be updated every 24 hours.