Recent trends in yoga therapies for psychiatric disorders

INTRODUCTION

The Indian approach to mental health is characterized by a blend of contemporary medical techniques and traditional methods. For mental health, Ayurveda, yoga, and meditation are popular practices. The two core concepts from yoga philosophy, the Panchakosha model and the Triguna theory, provide a more comprehensive and holistic approach to addressing mental health issues.^1,2,3 The Panchakosha model is a fundamental yogic concept that views human existence as comprising five interconnected layers or sheaths: the physical, energy, mental, wisdom, and bliss bodies. Each layer is seen as integral to the overall health and well-being of an individual.⁴ According to this model, mental health problems are not isolated to the mind or body but result from imbalances across all these layers.⁵ For instance, cognitive impairments in conditions like early psychosis may stem from disturbances in the Manomaya Kosha (the mental body), while emotional distress might be linked to imbalances in the Pranayama (energy) or Anandamaya Koshas (bliss body).^1,2,5 Yoga therapy, by addressing each of these layers, offers a holistic treatment approach that promotes healing on multiple levels, rather than focusing solely on symptom management. The Triguna theory further complements this framework by explaining mental and emotional states as the result of the interplay of three basic qualities, or gunas: Sattva, Rajas, and Tama.^3-6 These gunas influence behavior, emotions, and cognition. Sattva is associated with balance, clarity, and wisdom; Rajas with activity, restlessness, and agitation; and Tamas with inertia, confusion, and lethargy.³ Imbalances in these gunas can manifest as psychological disorders. For example, an excess of Rajas may lead to anxiety, while an overabundance of Tamas could contribute to depression. Yoga therapy seeks to increase Sattva and reduce Rajas and Tamas, thereby fostering emotional stability, mental clarity, and overall well-being.^3-6

Furthermore, there is a growing awareness of mental health issues, which has resulted in more people having access to counselling and psychiatric care. Nonetheless, stigma and a lack of resources continue to be obstacles in India's fight against mental illness. To provide complete mental healthcare, efforts are being undertaken to integrate traditional and modern techniques.⁷ Modern psychological models also play a role in this framework. Traditional treatments for disorders like anxiety, depression, and schizophrenia often involve pharmacological and psychotherapeutic interventions.^8,9 However, residual symptoms such as cognitive impairments, emotional dysregulation, and chronic stress frequently persist.¹⁰ Yoga therapy, as positioned in this paper, complements conventional methods by addressing these lingering issues. It improves cognitive functioning, reduces stress, and enhances emotional regulation, thus filling gaps left by traditional treatments.^5,10-13 This integrative approach ensures that patients experience more comprehensive relief and long-term benefits.

The theoretical framework of this paper is grounded in a synthesis of ancient yogic philosophy and modern psychological approaches to mental health treatment. Additionally, the paper emphasizes the critical role of the mind-body connection, a concept central to both yoga philosophy and modern holistic health approaches. Through the combination of physical postures, breath control, and meditation, yoga therapy fosters this connection, helping individuals with psychological disorders develop greater self-awareness and emotional control.^11-14 This integrated mind-body approach is crucial for treating disorders such as anxiety, depression, and psychosis, where emotional dysregulation and cognitive impairments are common.⁵

By nurturing both mind and body, yoga therapy promotes not only the relief of symptoms but also a deeper sense of well-being and self-regulation.⁵ Different techniques regarding schools of yoga provide day-to-day methods for integrating mind and body to treat psychological disorders. Sudarshan Kriya Yoga (SKY) aims at developing patterns of breathing to reduce the impact of stress response and to lower some disease states including anxiety or depression.¹⁵ Hatha Yoga mainly deals in postures (asanas), breathing exercises (pranayama) and meditation is also included, thus it can be beneficial for relieving stress and improving emotions.⁵ An active and complex type of Ashtanga yoga where certain sequences of postures are accomplished in harmony with breath is effective in awakening the mind and helping to discipline it.⁶ The style of Iyengar yoga which is strict, precise, correct alignment and usage of props is efficient for people with constraints in movement or persons with chronic diseases.^16,17

Kundalini yoga combines exercises, postures, and caught breath to encourage the improvement of spirit, endurance, and consciousness levels. Like it, Vinyasa yoga combines flowing movements with breathing patterns and its exercises help to develop mindfulness as well as cardiovascular fitness.¹⁸ Sivananda yoga approach includes control of breathing, relaxation techniques, proper diet and meditation, which helps to maintain balance and lessen stress.¹⁹ Last, Laughter Yoga, voluntary laughter and rhythmic breathing practices enhance mood tone and extend social interactions.^20,21 Collectively, these various methods will be compatible with the Pancha Kosha model and Triguna theory, and can be used as tools for cognitive enhancement, emotion management and general wellbeing.^1-3 As psychological disorders become more prevalent worldwide, there is an increasing need for therapies that are accessible, affordable, and effective.^22,23 Yoga, as a complementary therapy, provides a mind-body connection that is not addressed by conventional treatments.^24,25 This study is essential to understand yoga's mechanisms in improving mental health and to offer an alternative therapeutic approach for psychological disorders, especially in regions with limited access to mental healthcare. This paper focuses on the implications of yoga therapy on psychological disorders, particularly on how yoga addresses cognitive impairments and emotional disturbances in mental health patients. The study analyzes the effectiveness of yoga on conditions like psychosis, schizophrenia, depression, and anxiety. It identifies the relationship between psychological disorders and yogic concepts like Panchakosha and Triguna, exploring the therapeutic gains through yoga practices. With an explosion in studies of yoga therapy in psychiatric disorders, a summary review of studies in the past 10 years (2014-2024) would be beneficial.

Aim

To review the available evidence on the therapeutic potential of yoga therapy in addressing psychological disorders, with a focus on cognitive impairment and emotional regulation.

Objective

To explore the impact of yoga therapy on cognitive functioning and emotional regulation in individuals with psychological disorders, such as early psychosis, schizophrenia, depression and anxiety. To examine the role of yogic concepts like the Panchakosha model and Triguna theory in therapeutic intervention, and their overall therapeutic effects on mental health.

PROCEDURE

This study has been conducted from secondary data sources like different research papers, journals and books. This is a review study, in which literature in English was evaluated using electronic search in the following databases; PubMed, Google Scholar, ScienceDirect and APApsycNet the search strategy included phrases or search terms like ‘yoga,’ ‘mental disorders,’ ‘psychiatric illness,’ ‘psychological disorders,’ ‘Pancha kosha,’ ‘triguna,’ ‘cognitive impairment,’ and ‘yoga therapy’ the literature for a period of 10 years is covered from 2014-2024. Two study team members collected 45 paper abstracts and assessed them according to inclusion criteria during the first assessment of the article titles 30 papers were deemed appropriate in accordance with the article’s arbitration, after which the full texts of the articles that were available were prepared.

While a wide range of mental health issues and psychological distress have been addressed by yoga, we have concentrated on the main general categories of mental health issues, which include depression, anxiety, schizophrenia, sleep issues, and cognitive impairments. This paper also includes Triguna and Pancha kosha through yoga therapy.

Studies on sub-threshold symptoms like coping and general well-being as well as those on people without a psychiatric diagnosis were excluded. This was done in an effort to reduce the likelihood that the effects being seen are just typical people's reactions to a recent occurrence. Thus, the literature review has adopted a convenient search strategy to collate the research data that is in accordance with the objective of the present paper along with the analysis yielding several valuable insights.

Note: This figure illustrates the research process, depicting each step taken in reviewing literature related to the implications of yoga therapy for psychological disorders, including database searches, article screening, and data analysis.

RESULTS

The results of extensive investigations into yoga therapy have indicated that it is efficacious in treating various kinds of psychological disorders such as early psychosis, schizophrenia, depression, anxiety, and PTSD. It is clearly established by studies that symptoms of all the above conditions have been significantly reduced. For instance, randomized controlled trials (RCTs) showed significant effects of Kundalini Yoga and Sudarshan Kriya Yoga (SKY) on anxiety, depression, and symptoms of PTSD, as improved mental health well-being in comparison to those in control groups.²⁶ Regular yoga therapy has proved to reduce stress levels and raise one's mood and relaxation is achieved when asanas, pranayama, and mindfulness exercises are combined together.^5,12,19 Improvement in self-regulation has led techniques such as SKY and mindful yoga to report decreases in the symptoms of anxiety and depression.^15-26 The combination of mindfulness-based therapies along with Hatha yoga showed an increase in mood tone and decrease in state anxiety.^5,27,28 With an improved quality of life and a calm mind, yoga helps people live with mental health conditions.^6-29 Finally, yoga therapy gives social support, which improves the emotional benefit of the practice.^20,21

Note: This table provides a summary of studies reviewed, outlining the subject matter, yoga models, methodologies, sample characteristics, and key findings. It highlights the effectiveness of various yoga therapies on symptoms across psychological disorders. Abbreviations: RCT: Randomized Control Trail; DASS: Depression Anxiety and Stress Scale; QALYs: Quality Adjusted Life Years; STAI: State Trait Anxiety Inventory; BDI: Beck Depression Inventory; HAMD: Hamilton Depression Rating Scale; HAMA: Hamilton Anxiety Scale; HRSA: Hamilton Rating Scale for Anxiety; HRSD: Hamilton Rating Scale for Depression; ZSAS: Zung Self-Rating Anxiety Scale; ZSDS: Zung Self-Rating Depression Scale; SCL-90: Symptom Checklist-90; MCI: Mild cognitive impairment; MET: Memory enhancement training; DMN: Default Mode Network; HKLTL: Hong Kong list learning test; CDS: Calgary depression scale; CRS: Compliance rating scale; MRI: Magnetic resonance imaging FRS: Figure rating scale; PANSS: Positive and negative syndrome scale; SF-36: The short form (36) health survey.

Yoga therapy also results in improved cognitive skills, from verbal fluency through working memory to attention.^13-30 For example, results from randomized controlled trials have shown more positive effects of Hatha yoga than other interventions on several cognitive domains in people with psychosis, such as improved verbal acquisition and increased attention.^5,7,12,31 The gains have been supported by structural brain changes, such as increased postcentral gyrus size, improved cerebral connectivity, and a drop in cortisol levels.²⁹ Improved functional connectivity between the anterior and posterior Default Mode Network (DMN) was highlighted in studies such as MET (Memory Enhancement Training) and was related to improved verbal and visuospatial memory.¹³

Yoga techniques such as the Iyengar and Ashtanga, which focus the minds and breaths of practitioners on particular postures and hold the asana, have proven scientifically beneficial in the clinical populations, including patients with early psychosis, to enhance the cognitive flexibility and the attention.^16,17 Assessment tools such as the PANSS and STAI are the commonly used to measure the yoga therapy outcomes.^27-30 Additional tools, such as the Hamilton Anxiety Scale (HAMA), the Beck Depression Inventory (BDI), and Quality of Life Assessments (QALYs), further support the efficacy of yoga in enhancing the mental health metrics.^32,33 Instruments like

MRI and neuropsychological testing such as the Stroop color and word tests, digit-span test, letter cancellation test, HKLTL, VO2 max test, PANSS, CDS, MRI, and FRS allow researchers to measure improvements in symptoms, quality of life etc.^29,30

Yoga is proving to be very effective in the treatment of mental illnesses today. Various yoga types, including Hatha, Kundalini, Ashtanga, and SKY, have been adopted into mental health treatments. All of these types of methods make yoga a very adaptable profile for mental health intervention as they meet different needs for treatment. Also, some of its claims have been emphasized in being blended with Cognitive Behavior Therapy for dysfunctional cognitive and physiological processes.³⁴ The majority of studies have conducted research on yoga therapy under the RCT scheme, which offers robust proof of efficacy.^{13,26,30,32,33,35,36}

Like qualitative studies and a couple of review papers conducting systematic reviews and meta-analyses.^{5,14,28,20,36} In a number of studies, substantial results were obtained as part of a controlled environment.^{11,12,17,26,31,37,38,39} However, this limits the generalizability degree due to the absence of long-term follow-up and intervention heterogeneity, which also proves the need for developing standard protocols. A few qualitative papers have discussed some of these concerns in detail.^5,14,28

DISCUSSION

Our paper aimed at reviewing the recent scientific literature on yoga therapy. It is India and the United States that led the research in yoga therapy for psychiatric disorders. The former takes up what is established as traditional yogic knowledge into experimentation, unlike the latter that emphasizes taking clinical and randomized trials. There are very few studies about these populations done outside the two aforementioned. This calls for cross-cultural research in order to generalize the findings internationally. Addressing this gap allows for designing yoga interventions for different populations while considering cultural specifics. Research across a wide variety of cultural and socioeconomic conditions will add to the understanding and make such therapy increasingly applicable in a global setting regarding differences in populations. There are numerous methodological issues, lack of randomized control trials, and poor reporting per se. Even though yoga treatment has huge evidence-based support in psychological issues, it has a lot of practical problems concerning behavioral approach and cultural adaptability and adherence to treatment in the long term. Future studies should set standardized procedures along with long-term follow-ups and change mechanisms approaches using cultural familiar methodology. This way yoga would be more publicly applicable and institutionalized in general mental health care.

FUTURE RECOMMENDATIONS

It would be valuable to allocate more time to understanding and expanding the methods of yoga therapy used for psychological disorders. More clinical practice recommendations for yoga therapy need to be developed and circulated among practitioners to advocate for wide use of these interventions. Yoga therapy has reserved indications such as chronic pain relief, stress-related disorders, and psychiatric conditions like depression and anxiety. Evidence from research supports the benefit of yoga involvement in symptoms of arthritis, cancer-related fatigue, and overall quality of life across diverse populations. But there are certain contraindications that include acute injuries, severe psychiatric conditions (e.g., acute psychosis), and medical conditions in which physical activity could worsen the severity of the situation. The same applies to specific health concerns, such as cardiovascular disorders or severe osteoporosis, and they will need further individualized approaches to yoga practice. As understanding the potential of yoga therapy continues to expand, it becomes necessary to establish clear guidelines for practicing yoga therapy for schizophrenia, depression, anxiety and other diseases. It is hence important that such protocols outline the kind, frequency, intensity, and the duration of yoga exercises to avow the finest outcome. Further, large sample size and longitudinal studies (follow-up approach) is required to assess the durability of yoga therapy on symptoms as well as cognitive impairments following a long-term basis. Additional research should focus on nuanced emotional responses, such as emotional resilience and long-term affect regulation, to further understand its therapeutic benefits.^12-40

Yoga-based interventions have been difficult to employ in India due to the absence of structured referral systems to provide the connecting line between psychiatrists and evidence-based training for yoga therapists in psychiatric disorders. For instance, by establishing a close collaborative effort between psychiatrists and yoga therapists at the Yoga Therapy Department of the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore, yoga has been successfully incorporated into psychiatric care. Under this multidisciplinary approach, psychiatrists evaluate the mental health status of the patients and refer them to yoga therapists, who carry out individualized interventions with yoga practices aimed at dealing with anxiety, depression, or post-traumatic stress disorder. Yet, integrative care is still wanting in India because there is not many yoga therapists trained for clinical work, in addition to the ignorance among professionals in the medical field about the beneficial effects of yoga therapy. Addressing this aspect needs urgent intervention with the establishment of more programs in academia and training institutes preparing yoga therapists for work in multidisciplinary teams. An example is NIMHANS being a role model for establishing such departments in other medical colleges and hospitals, which would pave the way for collaborative efforts of psychiatrists and yoga therapists in developing comprehensive patient treatment plans for better outcomes in mental health care. Further emphasis should be placed on pharmacological and psychotherapy and their combinations with the yoga therapy that will maximize the synergy effect while avoiding or minimizing possible side-effects. Specific to yoga, further research is required on how best to deliver yoga interventions to different populations and enhance the global applicability of yoga therapy. These advancements will create a larger body of knowledge that supports the use of Yoga therapy in treatment while expanding the use of yoga, as an effective, affordable, and holistic treatment modality in a mentally ill population.

Research in yoga therapy has been relatively less focused on the mechanisms of change than the uses of yoga in various therapeutic practices. Some papers like point out to this gap in the field and emphasize the need for detailed exploration of the therapeutic effects of yoga. Riley and Park (2015), carried out a systematic review aimed at understanding the effects of yoga and stress on how to reduce it.^10-41 The emphasis of their work was that yoga has shown beneficial promise as a therapeutic intervention, particularly in its stress-relieving ability, and that there is an insufficient amount of empirical literature exploring mechanisms behind what it does. Thus, further reviews by Riley and Park (2015) emphasized that future studies must address the clearly defined pathways-through which yoga effects change-neurobiological, psychological, and behavioral processes. According to Töbelmann et al (2023), a yoga-based group intervention designed for inpatients with schizophrenia spectrum disorder was evaluated in this longitudinal qualitative study as to its mechanisms of action. The implications of how yoga may work in the realms of psychological and emotional states and what contribution the existence of such pathways might make in aiding recovery in this particular population were revealed. But the study highlighted a broader issue that most research on yoga therapy mainly focuses on outcome measures such as, reduced symptomatology or improvement in quality of life, often overlooking the mechanism or pathway through which these benefits occur, which also known as intermediate measures.

Mechanisms which change yoga therapy are important in enhancing the efficiency of intervention, being more specific and refined. Knowing which component of yoga gives rise to its therapeutic benefit allows a practitioner to design individualized interventions using breath-based techniques for anxiety or mindfulness centered practices for depression. Furthermore, as such mechanisms are truly defined, the credibility of yoga therapy increases exponentially, hence making it accepted more widely in medical and research organizations. Nonetheless, there are some challenges in those investigations into these mechanisms.

The multifaceted nature of yoga-the physical postures, breathwork, and meditation renders it challenging for researchers to pinpoint the specific mechanisms by which they yield its benefits. In addition, much of the literature suffers from poor methodological designs, such as lack of randomized controlled trials that are seen as necessary in establishing convincing evidence. Another main obstacle in measuring mechanisms like mindfulness or physiological changes is the heterogeneity and inadequacy of tools used for this purpose, mostly due to the fact that these instruments have not been designed especially for the research on yoga. Although yoga therapy has been established as widely applicable to many therapeutic benefits, its mechanism for doing so is still poorly defined. The future research should therefore attempt to mitigate this drawback by employing robust methodologies, consistent measurement tools, and interdisciplinary approaches to uncover the convoluted pathways through which yoga promotes healing and well-being.

CONCLUSION

The study has examined the impact of yoga therapy on psychological disorders. The study has identified potential benefits for symptom reduction, quality of life enhancement, and the development of physical, mental, social, intellectual, emotional, and spiritual well-being—that is, improving overall well-being yoga therapy appears to be a valuable complementary approach in the management of psychological disorders. The empirical evidence underscores the efficacy of yoga in alleviating symptoms of psychological disorders such as anxiety, depression, PTSD, schizophrenia, and cognitive impairments. Regular yoga practice has been shown to improve cognitive functions, emotional regulation, and quality of life while reducing stress, anxiety, and depressive symptoms. The diverse range of yoga techniques, including Hatha, Kundalini, Sudarshan Kriya, and Ashtanga, provides flexible interventions tailored to individual needs, further broadening its applicability. Therefore, it seems that Yoga can promote calmness, more energy and attention, and a desire to interact with life. The study contributes to our understanding of psycho-spiritual wellbeing is promoted via the Pancha Kosha model, also there is a favorable correlation between sattva and wellbeing and there is a negative correlation between wellbeing and Rajas and Tamas. By addressing Yoga, posing ways to support improved mental wellness among the populace. Yoga has the potential to complement and enhance conventional treatments, paving the way for a more holistic and effective mental health care system.

ACKNOWLEDGEMENTS

Heartfelt thanks is conveyed to the organizers of the conference PRAJNA and the knowledge partner Chanakya University for providing the opportunity to present and accept this concept. Gratitude is extended to all the previous researchers whose work has guided this study and contributed to the development of this paper. Appreciation is also expressed to the Department of Psychology, M. S. Ramaiah University of Applied Sciences, for its constant support and encouragement.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

REFERENCES

1. 1. Devarajan E, Shridharan S, Basavaraddi IV. Effect of Y Break protocol on working populations at Pancha Kosha level. Int Internal Med J. 2023;1(4):197-204.
2. 2. Mishra YJ, Sunayana J, Anjaly RK. Critical analysis of Panchakosha theory of yoga philosophy. World J Pharm Res. 2019;8(13):413-20.
3. 3. Khanna P, Singh K, Singla S, Verma V. Relationship between Triguna theory and well-being indicators. Int J Yoga Philos Psychol Parapsychol. 2013;1(2):69-74.
4. 4. Raina MK. The levels of human consciousness and creative functioning: Insights from the theory of five sheaths of consciousness. J Transpers Psychol. 2016;48(2):168-89.
5. 5. Sistig B, Lambrecht I, Friedman SH. Journey back into body and soul – an exploration of mindful yoga with psychosis. Psychosis. 2015;7(1):25-36.
6. 6. Mewada A, Keswani J, Sharma H, Tewani G, Nair PK. Ashtanga yoga ethics-based yoga versus general yoga on anthropometric indices, Trigunas, and quality of life in abdominal obesity: a randomized control trial. Int J Yoga. 2022;15(2):130-36.
7. 7. Varambally S, Gangadhar BN. Yoga and traditional healing methods in mental health. Mental Health and Illness Worldwide. Singapore: Springer. 2020;297-326.
8. 8. Ebert DD, Van Daele T, Nordgreen T, Karekla M, Compare A, Zarbo C, et al. Internet- and mobile-based psychological interventions: applications, efficacy, and potential for improving mental health. Eur Psychol. 2018;23(2):167-87.
9. 9. Turner DT, Van Der Gaag M, Karyotaki E, Cuijpers P. Psychological interventions for psychosis: A meta-analysis of comparative outcome studies. Am J Psychiatry. 2014;171(5):523-38.
10. 10. Riley KE, Park CL. How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health Psychol Rev. 2015;9(3):379-96.
11. 11. Ali M, Oble MJP, Sonia SN, George S, Shahi SR, Ali Z, et al. A systematic review of quantitative and qualitative results of randomized controlled trials assessing the effect of yoga in adult women with post-traumatic stress disorder: what is known so far. Cureus. 2023;15(10):e47765.
12. 12. Ikai S, Suzuki T, Uchida H, Saruta J, Tsukinoki K, Fujii Y, et al. Effects of weekly one-hour Hatha yoga therapy on resilience and stress levels in patients with schizophrenia-spectrum disorders: an eight-week randomized controlled trial. J Altern Complement Med. 2014;20(11):823-30.
13. 13. Brenes GA, Sohl S, Wells RE, Befus D, Campos CL, Danhauer SC. The effects of yoga on patients with mild cognitive impairment and dementia: a scoping review. Am J Geriatr Psychiatry. 2019;27(2):188-97.
14. 14. Patidar K, Yadav P. Yoga for psychiatric disorders: A review. Int J Sci Res. 2024;13(3):1869-75.
15. 15. Doria S, De Vuono A, Sanlorenzo R, Irtelli F, Mencacci C. Anti-anxiety efficacy of Sudarshan Kriya Yoga in general anxiety disorder: a multicomponent yoga-based breath intervention program for patients suffering from generalized anxiety disorder with or without comorbidities. J Affect Disord. 2015;184:310-7.
16. 16. Hainsworth KR, Liu XC, Simpson PM, Swartz AM, Linneman N, Tran ST, et al. A pilot study of Iyengar yoga for pediatric obesity: effects on gait and emotional functioning. Children. 2018;5(7):92.
17. 17. Scott TM, Gerbarg PL, Silveri MM, Nielsen GH, Owen L, Nyer M, et al. Psychological function, Iyengar yoga, and coherent breathing: a randomized controlled dosing study. J Psychiatr Pract. 2019;25(6):437-50.
18. 18. Choi MD, Marks C, Landis-Piwowar K, Payter C. The effects of Vinyasa yoga on cardiovascular and physical fitness as well as psychological profiles of well-being. FASEB J. 2017;31(1):lb742.
19. 19. Bartos HK. Modern transnational yoga. London: Routledge. 2021.
20. 20. Brinsley J, Schuch F, Lederman O, Girard D, Smout M, Immink MA, et al. Effects of yoga on depressive symptoms in people with mental disorders: a systematic review and meta-analysis. Br J Sports Med. 2021;55(17):992-1000.
21. 21. Gard T, Noggle JJ, Park CL, Vago DR, Wilson A. Potential self-regulatory mechanisms of yoga for psychological health. Front Hum Neurosci. 2014;8:770.
22. 22. Wainberg ML, Scorza P, Shultz JM, Helpman L, Mootz JJ, Johnson KA, et al. Challenges and opportunities in global mental health: a research-to-practice perspective. Curr Psychiatry Rep. 2017;19(5):28.
23. 23. Kazdin AE. Interventions in everyday life to improve mental health and reduce symptoms of psychiatric disorders. Am Psychol. 2023;79(2):185-209.
24. 24. Kamradt JM. Integrating yoga into psychotherapy: the ethics of moving from the mind to the mat. Complement Ther Clin Pract. 2017;27:27-30.
25. 25. Bennetts A. How does yoga practice and therapy yield psychological benefits? A review and model of transdiagnostic processes. Complement Ther Clin Pract. 2021;46:101514.
26. 26. Giridharan S, Pandiyan B. A path to resilience: the impact of school-based yoga on adolescent mental well-being. Cureus. 2024;16(11):e73604.
27. 27. McGuire D, Shannon A, Somaiya J, Brown E, O’Donoghue B. A pilot study of a yoga intervention for the treatment of anxiety in young people with early psychosis. Early Interv Psychiatry. 2022;16(2):200-4.
28. 28. Sathyanarayanan G, Vengadavaradan A, Bharadwaj B. Role of yoga and mindfulness in severe mental illnesses: a narrative review. Int J Yoga. 2018;12(1):3-28.
29. 29. Chen EYH, Lin J, Lee EHM, Chang WC, Chan SKW, Hui CLM. Yoga exercise for cognitive impairment in psychotic disorders. Schizophr Res. 2014;153(1):S26.
30. 30. Lin J, Chan SK, Lee EH, Chang WC, Tse M, Su WW, et al. Aerobic exercise and yoga improve neurocognitive function in women with early psychosis. NPJ Schizophr. 2015;1(1):15047.
31. 31. Woodward ML, Lin J, Gicas KM, Su W, Hui CLM, Honer WG, et al. Medial temporal lobe cortical changes in response to exercise interventions in people with early psychosis: a randomized controlled trial. Schizophr Res. 2020;223:87-95.
32. 32. Wu Y, Yan D, Yang J. Effectiveness of yoga for major depressive disorder: a systematic review and meta-analysis. Front Psychiatry. 2023;14:1138205.
33. 33. Vollbehr NK, Stant AD, Hoenders HR, Bartels-Velthuis AA, Nauta MH, Castelein S, et al. Cost-effectiveness of a mindful yoga intervention added to treatment as usual for young women with major depressive disorder versus treatment as usual only. Psychiatry Res. 2023;333:115692.
34. 34. Khalsa MK, Greiner-Ferris JM, Hofmann SG, Khalsa SBS. Yoga-enhanced cognitive behavioral therapy (Y-CBT) for anxiety management: a pilot study. Clin Psychol Psychother. 2015;22(4):364-71.
35. 35. Chobe S, Chobe M, Metri K, Patra SK, Nagaratna R. Impact of yoga on cognition and mental health among elderly: a systematic review. Complement Ther clin pract. 2020;52:102421.
36. 36. Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013;30(11):1068-83.
37. 37. Ikai S, Uchida H, Suzuki T, Tsunoda K, Mimura M, Fujii Y. Effects of yoga therapy on postural stability in patients with schizophrenia-spectrum disorders: a single-blind randomized controlled trial. J Psychiatr Res. 2013;47(11):1744-50.
38. 38. Nejadghaderi SA, Mousavi SE, Fazlollahi A, Asghari KM, Garfin DR. Efficacy of yoga for posttraumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials. Psychiatry Res. 2024;340:116098.
39. 39. Varambally S, Vidyendaran S, Sajjanar M, Thirthalli J, Hamza A, Nagendra HR, et al. Yoga-based intervention for caregivers of outpatients with psychosis: a randomized controlled pilot study. Asian J Psychiatr. 2013;6(2):141-5.
40. 40. Menezes CB, Dalpiaz NR, Kiesow LG, Sperb W, Hertzberg J, Oliveira AA. Yoga and emotion regulation: a review of primary psychological outcomes and their physiological correlates. Psychol Neurosci. 2015;8(1):82-101.
41. 41. Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, et al. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders: a longitudinal qualitative study. Front Psychiatry. 2023;14:1086468.
42. 42. Adams EV, Townsend J. A systematic review of yoga and schizophrenia spectrum disorders: Implications for recreational therapy practitioners. Am J Recreat Ther. 2018;17(2):37-47.
43. 43. Cramer H, Lauche R, Anheyer D, Pilkington K, de Manincor M, Dobos G, et al. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2018;35(9):830-43.