Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 7:14:1086468.
doi: 10.3389/fpsyt.2023.1086468. eCollection 2023.

Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study

Laura Töbelmann  1 , Inge Hahne  1 , Theresa Schulze  1 , Niklas Bergmann  1 , Lukas Fuchs  1 , Marco Zierhut  1 , Eric Hahn  1 , Kerem Böge  1
Affiliations

Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study

Laura Töbelmann et al. Front Psychiatry. .

Abstract

Background: Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting.

Material and methods: A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes.

Results: At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI.

Conclusion: Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.

Keywords: longitudinal qualitative study; mind-body medicine; mindfulness; schizophrenia spectrum and other psychotic disorder; yoga.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study design.
FIGURE 2
FIGURE 2
Yoga-based group intervention (YoGI’s) mechanisms of change.
FIGURE 3
FIGURE 3
Longitudinal experience of yoga-based group intervention (YoGI).
See this image and copyright information in PMC

References

    1. Gühne U, Salize HJ. Wie viele menschen in deutschland sind schwer psychisch krank? Psychiatrische Praxis. (2015) 42:9. - PubMed
    1. Owen MJ, Sawa A, Mortensen PB. Schizophrenia. Lancet. (2016) 388:86–97. 10.1016/s0140-673601121-6 - DOI - PMC - PubMed
    1. Fusar-Poli P, Nelson B, Valmaggia L, Yung AR, McGuire PK. Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull. (2014) 40:120–31. 10.1093/schbul/sbs136 - DOI - PMC - PubMed
    1. Moritz S, Schmidt SJ, Lüdtke T, Braunschneider LE, Manske A, Schneider BC, et al. Post-psychotic depression: paranoia and the damage done. Schizophr Res. (2019) 211:79–85. 10.1016/j.schres.2019.06.022 - DOI - PubMed
    1. Amogne G, Alemu T, Tadesse T, Mullu A. Magnitude of metabolic syndrome and its predictors among patients on second-generation antipsychotic drugs at six psychiatry clinics and mental hospitals, in addis ababa, ethiopia, 2019; multicenter cross-sectional study. Diabet Metab Syndr. (2021) 15:102187. 10.1016/j.dsx.2021.102187 - DOI - PubMed