Efficacy of Adjunctive Yoga Therapy in Patients with Major Depressive Disorder: A 12-week Randomised Controlled Trial from a Tertiary Care Setting in India

Abstract

Background: Major depressive disorder (MDD) is a leading cause of disability worldwide, and pharmacotherapy alone produces full remission in fewer than half of treated patients. Adjunctive yoga has emerged as a low-cost, culturally congruent intervention, but highquality randomised data from Indian settings remain limited. The present trial evaluated the efficacy of a structured 12-week yoga programme added to standard selective serotonin reuptake inhibitor (SSRI) therapy in adults with moderate MDD. Methods: A parallel-group, single-blind, randomised controlled trial was conducted in the Department of Psychiatry of a tertiary-care teaching hospital. Adults aged 18–60 years with DSM-5 MDD and a baseline 17-item Hamilton Depression Rating Scale (HAM-D) score of 18–25 (n = 130) were randomised 1:1 to receive either SSRI plus adjunctive yoga (n = 65) or SSRI alone (n = 65). The yoga arm received supervised hour-long sessions five days per week for the first four weeks, tapering to home practice with weekly review. The primary outcome was change in HAM-D score at 12 weeks; secondary outcomes included response (≥50% reduction in HAM-D), remission (HAM-D ≤7), Beck Depression Inventory-II (BDI-II), WHO Quality of Life-BREF (WHOQOL-BREF), and perceived stress. Results: A total of 120 participants (60 per arm) completed the trial (per-protocol drop-out 6.7% vs 10.0%; p = 0.508). Mean HAM-D scores at 12 weeks were 10.3 ± 4.0 in the yoga arm versus 15.7 ± 4.3 in controls (mean difference 5.4 points; 95% CI 3.91–6.89; p < 0.001). Response (73.3% vs 50.0%; p = 0.008) and remission (41.7% vs 21.7%; p = 0.018) were significantly higher in the yoga arm. WHOQOL-BREF scores improved significantly in all four domains in the yoga arm (all p < 0.05). No serious adverse events attributable to yoga were reported. Conclusion: A structured 12-week adjunctive yoga programme produced statistically and clinically meaningful improvements in depressive symptoms, response, remission and quality of life when added to SSRI therapy in adults with moderate MDD. Adjunctive yoga appears safe, acceptable and effective in Indian psychiatric practice.