Commensurate with increasing public interest in the mood benefits of yoga, the number of randomized controlled trials (RCTs) investigating yoga for depression grew significantly in the decade from 2005 to 2015, with several systematic reviews conducted in succession [61–67] to evaluate these studies. In all RCTs included in these reviews, the primary intervention involved yoga-based postures, breathing exercises, and/or techniques for meditation or relaxation. By the end of 2015, 24 RCTs of yoga for depression [68–91] were identified via systematic reviews, nearly a 5-fold increase from the 5 RCTs initially identified in 2005 by Pilkington et al [61]. Despite the increasing number of RCTs examining mood effects of yoga, investigation remains at an early stage of development. While most trials report measureable mood benefits from yoga, this collective evidence base must be interpreted with caution, as it may reflect publication bias toward positive studies. Moreover, systematic reviews [61,62,65,67] indicate that most published RCTs on yoga for depression are hampered by methodological problems. For example, few studies provided adequate information on methods for randomizing participants, concealing allocation schedule, blinding assessors and implementing other steps to minimize bias in outcomes. Blinding to the yoga allocation was typically not possible, but steps to address performance bias were not mentioned. Individual trials have tended toward small sample sizes and selective study populations—such as prenatal women, psychiatric inpatients, young adults, or community seniors—raising questions about generalizability of findings to the wider population with depression. From study to study, baseline symptoms of participants varied considerably: in some trials, participants were healthy with no significant mood symptoms [76,79,86,88]; in other trials, participants reported elevated depressive symptoms but had no diagnosed depressive disorders [73,77,80,82,91,92]; in yet other trials, participants were diagnosed with either major depression or dysthymia [78,81,83–85,87,89,93]; and finally, in a few trials, participants were diagnosed with only major depression [69–72,74,90]. While some trials specifically evaluated yoga as an adjunct to conventional depression care [68,69,74,90], others allowed some degree of co-intervention with conventional care in an unsystematic manner, confounding potential mood effects of yoga [78,81,83–85,87,92,93]. Additionally, the heterogeneity of yoga interventions used in various RCTs limits the ability to pool data for meta-analysis and draw conclusions about efficacy. Nonetheless, with caveats regarding these limitations, authors of 5 systematic reviews [61–64,67] and 2 meta-analyses [65,66] conclude there is preliminary evidence for the efficacy of yoga in the acute treatment of depression.
相稱瑜伽的好處情緒增加公共利益,隨機對照試驗(RCT)調查瑜伽抑鬱症的人數在十年顯著上升2005至2015年,在繼承[61-67]進行了多次系統評價,以評估這些學習。在包括在這些評論中,主要涉及的干預基於瑜伽姿勢,呼吸練習,和/或技術的冥想或放鬆所有的隨機對照試驗。由2015年年底,用於治療抑鬱症[68-91]瑜伽24經由隨機對照試驗系統評價進行了鑑定,從由Pilkington等人[61]在2005年最初鑑定的5個隨機對照試驗近5倍的增加。儘管越來越多的隨機對照試驗研究瑜伽的意境效果,調查仍然處於發展的早期階段。雖然大多數試驗報告從可測量的瑜伽心情的好處,這種集體的證據基礎,必須謹慎解釋,因為這可能反映了向正研究發表偏倚。此外,系統評價[61,62,65,67]表明抑鬱瑜伽,大多數出版隨機對照試驗方法方面的問題的阻礙。例如,一些研究的參與者隨機化,隱瞞分配表,盲法評估和實施其他步驟,以盡量減少偏差的結果提供方法的足夠信息。致盲的瑜伽分配是通常是不可能的,但沒有提到的步驟來解決性能偏差。個別試驗已經對小樣本量和選擇性研究人群,如產前婦女,精神科住院病人,年輕的成年人,或老年人的社區提高對發現與抑鬱症更廣泛的人群的普遍性問題趨向。從研究到研究中,參與者的基線症狀差異很大:在一些試驗中,參與者沒有顯著情緒症狀[76,79,86,88]健康; 在其他試驗中,參加者報告升高抑鬱症狀但沒有確診的抑鬱症[73,77,80,82,91,92]; 在另外的試驗中,參與者被確診患有任何嚴重抑鬱症或精神抑鬱症[78,81,83-85,87,89,93] 最後,在幾個試驗中,參與者被診斷為只有抑鬱症[69-72,74,90]。雖然一些試驗具體評價瑜伽作為輔助常規抑鬱護理[68,69,74,90],其他允許某種程度的共干預與常規護理在非系統化方式,混雜瑜伽[78,81的潛在情緒的影響, 83-85,87,92,93]。另外,在不同的隨機對照試驗用瑜伽干預的異質性限制了能力池數據進行匯總分析,並得出結論的功效。儘管如此,與有關這些限制警告,5系統評價[61-64,67]和2薈萃分析[65,66]作者認為有瑜伽在急性治療抑鬱症的療效初步證據。
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隨著公眾對瑜伽對情緒益處的興趣不斷增加,從2005年到2015年的十年間,研究瑜伽治療抑鬱症的隨機對照試驗(RCT)數量顯著增加,連續進行了幾次系統性的評估研究[61–67]。在這些綜述中包括的所有隨機對照試驗中,主要干預包括瑜伽姿勢、呼吸練習和/或冥想或放鬆技巧。到2015年底,通過系統回顧,共發現24個瑜伽治療抑鬱症的隨機對照試驗【68–91】,幾乎是皮爾金頓等人2005年最初確定的5個隨機對照試驗【61】的5倍。儘管越來越多的RCT檢查瑜伽的情緒影響,調查仍處於早期發展階段。雖然大多數試驗報告可量測的情緒受益於瑜伽,但這一集體證據基礎必須謹慎解釋,因為它可能反映出對積極研究的出版偏見。此外,系統綜述[61,62,65,67]表明,大多數已發表的關於瑜伽治療抑鬱症的RCT都受到方法學問題的阻礙。例如,很少有研究提供足够的資訊,說明隨機參與者的方法,隱藏分配計畫,盲目評估和實施其他步驟以儘量減少結果的偏差。通常情况下,不可能對瑜伽的分配盲目,但沒有提到解决表現偏差的步驟。個體試驗傾向於小樣本和選擇性研究人群,如產前婦女、精神病住院患者、年輕人或社區老年人,這就對更廣泛的抑鬱症人群的研究結果的普遍性提出了疑問。從一項研究到另一項研究,受試者的基線症狀變化很大:在一些試驗中,受試者健康,沒有明顯的情緒症狀[76,79,86,88];在其他試驗中,受試者報告抑鬱症狀升高,但沒有診斷出抑鬱障礙[ 73,77,80,82,91,92];在其他試驗中,參與者被診斷為重度抑鬱或心境惡劣[78,81,83–85,87,89,93];最後,在一些試驗中,參與者被診斷為重度抑鬱[69–72,74,90]。雖然一些試驗特別評估瑜伽作為傳統抑鬱症護理的輔助手段[68,69,74,90],但其他試驗允許以非系統的管道與傳統護理進行某種程度的聯合干預,混淆了瑜伽的潜在情緒影響[78,81,83–85,87,92,93]。此外,在各種RCT中使用的瑜伽干預的異質性限制了收集數據進行元分析和得出療效結論的能力。儘管如此,關於這些局限性的警告,5篇系統綜述[61–64,67]和2篇薈萃分析[65,66]的作者得出結論,瑜伽在急性抑鬱症治療中的療效有初步證據。<br>
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