This proposal seeks support for an exploratory study assessing the feasibility and promise of studying yoga for the treatment of persons with generalized anxiety disorder (GAD). GAD is a chronic and debilitating condition that affects 5% of the general population and up to 15% of those in primary care clinics. Even the best treatment options result in improvement in only 60-70% of patients and less than half experience full recovery. Thus, most patients remain at least somewhat symptomatic or fail to respond at all despite standard treatments. Therefore, the development and testing of additional treatments for GAD is needed. New psychosocial treatments would be particularly welcome in primary care settings where persons with GAD often go under-treated, in part due to the lack of therapists trained in deliver cognitive behavior therapies. Yoga naturally combines four treatments (yogic breathing, meditation, exercise, and relaxation) that each independently show promise in the treatment of anxiety disorders. In light of this supporting research, yoga is a very attractive prospective treatment for GAD. In this study, we will collaborate with a national yoga expert to create a yoga treatment specifically for GAD that can be reproduced for future use. We will test the efficiency of two different recruitment mechanisms and enroll 40 subjects with GAD from primary care clinics at Beth Israel Deaconess Medical Center (BIDMC). Subjects will be randomized to receive either yoga treatment or wait list control for a 12-week period, allowing us to obtain preliminary estimates of the safety and efficacy of yoga as a treatment for GAD. We will also obtain preliminary data on patient factors that could either facilitate or hinder the use of yoga as a therapy and test whether unique positive psychospiritual outcomes are associated with use of our yoga treatment. This study will involve unique collaboration between researchers and clinicians from the Department of Psychiatry at Massachusetts General Hospital, the Division of General Medicine and Primary Care at BIDMC, and the Division for Research and Education in Complementary and Integrative Medical Therapies at Harvard Medical School. Upon demonstration of feasibility and promise, we will be well positioned to prepare a competitive grant proposal to evaluate the effectiveness of yoga as a new treatment for persons with GAD.
