HHRI studying tele-psychotherapy vs. tele-yoga for depression

Hennepin Healthcare Research Institute (HHRI) has been approved for $1.4 million of an $8.7 million award by the Patient-Centered Outcomes Research Institute (PCORI) to study the efficacy of Hatha Yoga as a treatment for depression.

Co-PIs Louisa Sylvia, PhD, of Massachusetts General Hospital (Harvard Medical School) and Lisa Uebelacker, PhD, of Butler Hospital (Brown University) are leading the multi-site trial. HHRI investigator Andrew Busch, PhD, is heading the study at Hennepin Healthcare. Dr. Busch’s lab is coordinating recruitment and retention of patients across Minnesota, one of four states recruiting for the study.

The study team will compare the effectiveness of yoga in decreasing depressive symptoms to behavioral activation, a psychotherapy that helps engage patients in meaningful activities and that has been shown to be effective in treating depression. The study will help determine whether yoga should be considered a first-line treatment for depression. Importantly, it could provide critical evidence for health insurance payers to consider yoga programs among their covered treatments for depression.

For the six-month study, 518 adults with depression will be randomized into two groups. One will have behavioral activation therapy with a community therapist via video or telephone. The other group will participate in weekly, hour-long yoga classes that will be presented online in real time. These classes will be structured to mirror typical community yoga classes.

The study team will also examine how certain types of people may do better in one or the other treatment, based on characteristics like severity of depression, age, or personal preference. In this way, the study seeks to improve outcomes for identifiable groups of patients. Outcomes will be measured not only by decrease in depressive symptoms but also by increase in aspects of well-being (joy, happiness).

The study will leverage the expertise of a variety of stakeholders, including patients with lived experience of depression, advocacy partners, yoga instructors, behavioral activation therapists, other clinicians, and insurers. Stakeholders will be involved in designing and implementing the study as well as in communicating study results to the public.

“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other healthcare stakeholders in a major study conducted in real-world settings, but also for its potential to answer an important question about whether yoga should be considered a first-line treatment for depression and fill a crucial evidence gap,” said PCORI Executive Director Nakela L. Cook, MD, MPH.

Over 19 million adults in the US suffer from a depressive illness every year. Existing therapies and medications can help some people feel better. However, there is a need for treatments that are more accessible, have fewer side effects, and may work for those who do not respond to existing treatments Mind-body approaches to health and well-being, like yoga, are becoming increasingly more popular. While there are scientific studies showing that yoga can help depressed people to feel better, it is not clear whether it works as well as other treatments for depression.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions.