Schizophrenia (SZ) is a common, severe disorder for which treatment is inadequate and unpredictable at present. Its causation is uncertain. Its lifetime prevalence is approximately 1% world-wide. It is estimated that there are approximately 2.2 million SZ patients in the USA at present and over twice this number in India. As it is a lifetime condition, SZ entails enormous morbidity and public health costs, world-wide. Cognitive impairment is a key disabling feature of SZ. The impairment affects functional outcome and employability, resulting in increased burden. Currently, medications offer only modest benefits for the cognitive dysfunction. Hence, non- pharmacological interventions are worth consideration. Yoga is known to enhance cognitive abilities in healthy persons. Our preliminary studies have shown for the first time that there may be remarkable improvement in selected cognitive domains among outpatients with SZ. The improvement is unlikely to be due to rater bias, as they were noted using a computerized neurocognitive battery. Since our preliminary studies involved an open trial, it is necessary to conduct more controlled studies. To evaluate our results further, we propose to test the effectiveness of yoga supplementation using a controlled single blind design in India. Outpatients with SZ (N=258) undergoing treatment at a large academic center in New Delhi, India will be randomly assigned to one of the three groups- yoga training (YT, N=86), physical exercise (PE, N=86) or treatment as usual (TAU, N=86). The YT group will undergo 21 days yoga supplementation, while the PE group will complete a 21 day systematic physical exercise training regime. The third group will have no such supplementation. All patients will receive appropriate medications and counseling. Cognitive state, symptom severity and overall function will be assessed at four time points: just before, immediately after, three months later and six months after completion of YT/PE supplementation. The evaluations will be conducted by raters blind to group status. Thus, we will test a novel method to supplement the beneficial effects of pharmacotherapy more rigorously than in our pilot studies. Demonstrable benefits from YT will motivate further studies to test other important issues, such as dose effects of YT, its temporal benefits and its interaction with medications.

Public Health Relevance

The proposed studies may lead to better treatment for schizophrenia using the ancient practice of Yoga. Our preliminary studies suggest significant beneficial effects of Yoga on cognitive function, which can be severely impaired in schizophrenia. The cognitive impairment is difficult to treat at present using medications.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
Research Project (R01)
Project #
4R01TW008289-04
Application #
8509641
Study Section
Special Emphasis Panel (ZRG1-BDA-L (52))
Program Officer
Light, Enid
Project Start
2010-08-01
Project End
2015-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
4
Fiscal Year
2013
Total Cost
$50,928
Indirect Cost
$3,772
Name
Dr Ram Manohar Lohia Hospital
Department
Type
DUNS #
916454635
City
New Delhi
State
Country
India
Zip Code
11000-5
Bhatia, Triptish; Mazumdar, Sati; Wood, Joel et al. (2017) A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia. Acta Neuropsychiatr 29:102-114
Jakhar, Kiran; Beniwal, Ram Pratap; Bhatia, Triptish et al. (2017) Self-harm and suicide attempts in Schizophrenia. Asian J Psychiatr 30:102-106
Bhatia, Triptish; Gettig, Elizabeth A; Gottesman, Irving I et al. (2016) Stratifying empiric risk of schizophrenia among first degree relatives using multiple predictors in two independent Indian samples. Asian J Psychiatr 24:79-84
Sharma, Srikant; Bhatia, Triptish; Mazumdar, Sati et al. (2016) Neurological soft signs and cognitive functions: Amongst euthymic bipolar I disorder cases, non-affected first degree relatives and healthy controls. Asian J Psychiatr 22:53-9
Singh, Sadhana; Singh, Kavita; Trivedi, Richa et al. (2016) Microstructural abnormalities of uncinate fasciculus as a function of impaired cognition in schizophrenia: A DTI study. J Biosci 41:419-26
Verma, Deepak; Srivastava, M K; Singh, Sunil K et al. (2016) Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders. Schizophr Res 178:12-16
Narayanan, Sreelatha S; Bhatia, Triptish; Velligan, Dawn I et al. (2015) A case control study of association between cognition and functional capacity in schizophrenia. Schizophr Res 169:165-168
Singh, Sadhana; Modi, Shilpi; Goyal, Satnam et al. (2015) Functional and structural abnormalities associated with empathy in patients with schizophrenia: An fMRI and VBM study. J Biosci 40:355-64
Choudhary, Mona; Kumar, Arvind; Tripathi, Madhavi et al. (2015) F-18 fluorodeoxyglucose positron emission tomography study of impaired emotion processing in first episode schizophrenia. Schizophr Res 162:103-7
Jakhar, Kiran; Bhatia, Triptish; Saha, Rahul et al. (2015) A cross sectional study of prevalence and correlates of current and past risks in schizophrenia. Asian J Psychiatr 14:36-41

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