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A literature search for clinical trials examining yoga for depression uncovered eight trials: 5 including individuals with clinical depression, and 3 for individuals with elevated depression symptoms. Although results from these trials are encouraging, they should be viewed as very preliminary because the trials, as a group, suffered from substantial methodological limitations. We would argue, however, that there are several reasons to consider constructing careful research on yoga for depression. First, current strategies for treating depression are not sufficient for many individuals, and patients have several concerns about existing treatments. Yoga may be an attractive alternative to or a good way to augment current depression treatment strategies. Second, aspects of yoga-including mindfulness promotion and exercise-are thought to be "active ingredients" of other successful treatments for depression. Third, there are plausible biological, psychological, and behavioral mechanisms by which yoga may have an impact on depression. We provide suggestions for the next steps in the study of yoga as a treatment for depression.

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clinicaltrials.gov Identifier: NCT00541957.

Background The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment. Methods We conducted a randomized controlled trial of weekly yoga classes (n = 63) vs. health education classes (Healthy Living Workshop, or HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning. Results At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b=−0.82, SE=0.88, p=0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = −1.38, SE = 0.57, p = 0.02). Fifty-one percent of yoga participants demonstrated a response (≥ 50% reduction in depression symptoms) at 6 month-follow-up, compared to 31% of HLW participants (OR = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time. Conclusions Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

Background Psychotic major depression (PMD) is a severe mental disorder characterized by high levels of illness severity, chronicity, impairment, and treatment resistance. However, most past research on PMD has been conducted in inpatient hospital samples, and relatively little is known about PMD patients presenting for treatment in the community specifically. Methods In this study, we examined the prevalence and clinical characteristics of PMD in a large sample (n = 2,500) of treatment-seeking outpatients who were administered structured clinical interviews by trained diagnosticians. Results Of the patients diagnosed with major depression, 5.3% had psychotic features. PMD patients were more likely to be members of a racial/ethnic minority and to have lower educational attainment compared to those with nonpsychotic major depression. In addition, PMD patients were found to have greater current depression severity, suicidal ideation, and social and work impairment. These patients also were more likely to have histories of suicide attempts and psychiatric hospitalizations, to report an earlier age of illness onset, and to meet criteria for chronic depression. In terms of psychiatric comorbidity, PMD patients had higher rates of certain anxiety disorders as well as more somatoform and cluster A personality disorders. Conclusions Results indicated that PMD was present in a relatively small percentage of treatment-seeking outpatients but was associated with disproportionately high levels of severity and impairment. Similarities and differences between the current findings and those from past research are discussed, including clinical implications for the identification and treatment of PMD in routine practice settings.

Early identification and treatment of social anxiety disorder (SAD) is critical to prevent development of a chronic course of symptoms, persistent functional impairment, and progressive psychiatric comorbidity. A small but growing literature supports the effectiveness of cognitive behavior therapy (CBT) for anxiety disorders, including SAD, in adolescence. The present randomized controlled trial evaluated the efficacy of group vs. individual CBT for adolescents with generalized SAD in relation to an educational/supportive psychotherapy that did not contain specific CBT elements. All three treatments were associated with significant reductions in symptoms and functional impairment, and in improved social skills. No differences between treatments emerged on measures of symptoms, but the CBT conditions demonstrated greater gains on behavioral measures. The implications of the findings are discussed. KeywordsSocial anxiety disorder; adolescence; social phobia; cognitive behavior therapy Address correspondence to: James D. Herbert, Department of Psychology, Drexel University, Mail Stop 988, 245 N. 15 th Street, Philadelphia, PA 19102-1192 or via james.herbert@drexel.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptSocial anxiety disorder (SAD), also known as social phobia, is characterized by a marked and persistent fear and/or avoidance of social situations in which one fears being negatively evaluated by others or being subjected to embarrassment (American Psychiatric Association, 2000). SAD is divided into two subtypes: generalized and non-generalized. Individuals with generalized SAD experience anxiety across most social situations, whereas those with the non-generalized subtype fear a specific social or performance situation (Hofmann, Albano, Heimberg, Tracey, Chorpita, & Barlow, 1999). SAD is widely believed to be among the most prevalent of psychiatric conditions, although most individuals with the disorder are never identified and do not obtain treatment (Chavira, Stein, Bailey, & Stein 2004;Kessler et al., 1994). Without treatment, SAD tends to follow a chronic, unremitting course. Onset is typically in the early teens, with a mean onset of 15.5 years (Schneier, Johnson, Hornig, Liebowitz, & Weissman, 1992). Although the vast majority of research on SAD has focused on adults, the early onset, chronicity, high levels of comorbidity, and substantial distress and functional impairment associated with the disorder highlight the critical importance of effective early ass...