Results

PurposeTo examine the current literature on the effects of alternative therapy, specifically yoga, on the quality of life in perinatal populations.

IntroductionWomen in the perinatal period are at an elevated risk for developing major depressive disorder, due to stresses and hormonal changes related to this reproductive period1. Studies have shown that 12.8% of women experience major depressive disorder in pregnancy2. While remission is used as a gauge to determine treatment efficacy, measurement of quality of life is important in order to understand her overall sense of wellbeing. Pharmacotherapy and psychotherapy have been proven as effective treatments for moderate/severe postpartum depression; however, several barriers may present

include inadequate access to trained medical/psychological professionals in remote areas, financial shortcomings, as well as concerns about medication pertaining to teratogenicity and secretion in the breastmilk. Hence, there is a growing need for alternative and complementary therapies as an adjunct to standard clinical care. Alternative therapies may be cost-effective and easier to implement into a busy lifestyle. Recent studies have shown that yoga may be an effective method to improve the quality of life in certain populations, such as pregnant women3 and those with schizophrenia4.

Arjun Nanda1,2, Jasmin Abizadeh 2,3,4 BA, Shaila Misri 2,3,4,5 MD FRCPC1 Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada, 2 Reproductive Mental Health Program, B.C. Children's & Women's Hospital, Vancouver, British Columbia, Canada, 3 Reproductive Mental

Health Program, St. Paul's Hospital, Vancouver, British Columbia, Canada, 4 BC Mental Health and Addiction Services, Provincial Health Services Authority, Vancouver, British Columbia, Canada , 5 Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada

References1Ohara M.W., Swain A.M. (1996). Rates and risk of postpartum depression A meta-analysis. IntRev Psychiatry, 8:37-54.2Bennett H.A., Einarson A., Taddio A., Koren G., Einarson, T.R. (2004). Prevalance of depression during pregnancy: systematic review. Obstet Gynecol, 103:698-709.3Rakhshani A., Maharana S., Raghuram N., Nagendra H.R., Venkatram P. (2010). Effects of integrated yoga on quality of life and interpersonal relationship of pregnant women. Qual Life Res, 19:1447-1455.4Duraiswamy G., Thirthali J., Nagendra H.R., Gangadhar B.N. (2007). Yoga therapy as an add-on treatment in the management of patients with schizophrenia a randomized controlled trial. ActaPsychiatr Scand, 116:226-232.5 Field T. (2010). Yoga clinical research review. Complement Ther Clin Prac, 17:1-86 Battle, C.L., Howard M., Castaneda M. (2010). Prenatal Yoga and Depression during Pregnancy. Birth, 37(4):353-3547Flefal KE, Kishiyama S, Zajdel D, Haas M, Oken BS (2007). Adherence to yoga and exercise interventions in a 6-month clinical trial. BMC Comp Alt Med, 7(37):1-7

ConclusionWhile several studies have suggested that yoga and other complementary treatments are efficacious as a supplement to conventional therapy for depression, more research is required in the treatment of perinatal populations as clinically, yoga is reported to be effective. Further familiarization of yoga as an integral aspect of healthcare is advocated.

DiscussionYoga as a complementary and alternative therapy was found to be beneficial for the researched populations in the majority of reviewed articles. In the majority of the studies, patients who participated in yoga treatment had less anxiety and depressive symptoms, and increased physical and mental functioning. Engagement in yoga substantially improved quality of life in several populations, and reduced stress in perinatal populations. An interesting finding was that in different areas around the world, approximately 10-20% of women in the perinatal period already engage in this practice as a complementary therapy5, and 88% of those suffering from antenatal depression are interested in practicing yoga as an adjunct to pharmacotherapy6. Additionally, one study found that adherence to yoga was high. Despite this, systematic research which measures integration of yoga in the treatment of perinatal depression and its impact on quality of life has yet to be done.

MethodsSelection criteria included searches made using a combination of the following terms: alternative therapy, yoga, depression, postpartum, pregnancy, perinatal, quality of life. Only articles published after 2006 were included. Systematic reviews, clinical trials, and case studies were included. Six online databases were searched (Biomedical Reference Collection: Comprehensive, Google Scholar, Medline, PsycBOOKS, PsycINFO, and PubMed). Relevant articles were examined; in total, 20 articles were reviewed.

Studies  pertaining  to  yoga

Anxiety

14%Stress

9%Cancer

9%

Perinatal  

population

27%

Quality  of  Life

18%

Depression

18%

Adherance

5%

Twenty articles met the selection criteria and were reviewed. Sixteen articles pertaining to yoga were identified: perinatal populations (6), depression (4), quality of life (4), anxiety (3), cancer (2), stress (2), and adherence to yoga as a treatment (1). Several of these articles addressed a variety of these sub-topics. Using the Short Form Health Survey-36 (SF-36), Menopausal Specific Quality of Life (MSQOL), Nottingham Health Profile, and the World Health Organization Quality of Life assessment (WHOQOL-100), several articles found a statistically significant increase in the quality of life of patients that engaged in yoga therapy. Depressive symptoms were substantially reduced in the target populations in the related review papers. No articles integrated all of the topicsof yoga, quality of life, and depression in the perinatal population. The remaining articles outlined other alternative treatments (omega-3 fatty acids, S-adenosyl-methionine (SAMe), bright light therapy, and exercise) that were shown to have positive effects alongside conventional treatment in perinatal populations for depression and impaired quality of life.

Yoga as a Complementary and Alternative Therapy for Improving the Quality of Life in Perinatal Women