Author: Shannahoff-Khalsa D1,2,3, Fernandes RY4, Pereira CAB5, March JS6, Leckman JF7, Golshan S2,8, Vieira MSR9, Polanczyk GV4, Miguel EC4, Shavitt RG4
1BioCircuits Institute, University of California, San Diego, La Jolla, CA, United States.
2Center for Integrative Medicine, University of California, San Diego, La Jolla, CA, United States.
3The Khalsa Foundation for Medical Science, Del Mar, CA, United States.
4The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.
5Mathematics and Statistics Institute, Statistics Department, University of São Paulo, São Paulo, Brazil.
6Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, United States.
7Child Study Center, Department of Pediatrics and Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
8Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.
9Hospital Israelita Albert Einstein, São Paulo, Brazil.
Conference/Journal: Front Psychiatry.
Date published: 2019 Nov 11
Other: Volume ID: 10 , Pages: 793 , Special Notes: doi: 10.3389/fpsyt.2019.00793. eCollection 2019. , Word Count: 377
Background: Obsessive-compulsive disorder (OCD) is often a life-long disorder with high psychosocial impairment. Serotonin reuptake inhibitors (SRIs) are the only FDA approved drugs, and approximately 50% of patients are non-responders when using a criterion of 25% to 35% improvement with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). About 30% are non-responders to combined first-line therapies (SRIs and exposure and response prevention). Previous research (one open, one randomized clinical trial) has demonstrated that Kundalini Yoga (KY) meditation can lead to an improvement in symptoms of obsessive-compulsive severity. We expand here with a larger trial. Design: This trial compared two parallel run groups [KY vs. Relaxation Response meditation (RR)]. Patients were randomly allocated based on gender and Y-BOCS scores. They were told two different (unnamed) types of meditation would be compared, and informed if one showed greater benefits, the groups would merge for 12 months using the more effective intervention. Raters were blind in Phase One (0-4.5 months) to patient assignments, but not in Phase Two. Main Outcome Measures: Primary outcome variable, clinician-administered Y-BOCS. Secondary scales: Dimensional Yale-Brown Obsessive Compulsive Scale (clinician-administered), Profile of Mood Scales, Beck Anxiety Inventory, Beck Depression Inventory, Clinical Global Impression, Short Form 36 Health Survey. Results: Phase One: Baseline Y-BOCS scores: KY mean = 26.46 (SD 5.124; N = 24), RR mean = 26.79 (SD = 4.578; N = 24). An intent-to-treat analysis with the last observation carried forward for dropouts showed statistically greater improvement with KY compared to RR on the Y-BOCS, and statistically greater improvement on five of six secondary measures. For completers, the Y-BOCS showed 40.4% improvement for KY (N = 16), 17.9% for RR (N = 11); 31.3% in KY were judged to be in remission compared to 9.1% in RR. KY completers showed greater improvement on five of six secondary measures. At the end of Phase Two (12 months), patients, drawn from the initial groups, who elected to receive KY continued to show improvement in their Y-BOCS scores. Conclusion: KY shows promise as an add-on option for OCD patients unresponsive to first line therapies. Future studies will establish KY's relative efficacy compared to Exposure and Response Prevention and/or medications, and the most effective treatment schedule. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01833442.
Copyright © 2019 Shannahoff-Khalsa, Fernandes, Pereira, March, Leckman, Golshan, Vieira, Polanczyk, Miguel and Shavitt.
KEYWORDS: Dimensional Yale-Brown Obsessive-Compulsive Scale; Yale-Brown Obsessive Compulsive Scale; anxiety/anxiety disorders; depression; mental health; mindfulness
PMID: 31780963 PMCID: PMC6859828 DOI: 10.3389/fpsyt.2019.00793