Yoga for depression and anxiety symptoms in people with cancer: A systematic review and meta-analysis

Author: Maria Gonzalez1, Michaela C Pascoe2, Guoyan Yang1, Michael de Manincor1, Suzanne Grant1,3, Judith Lacey1,3,4, Joseph Firth1,5, Jerome Sarris1,6
1 NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.
2 Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.
3 Chris O'Brien Lifehouse Comprehensive Cancer Centre, Camperdown, New South Wales, Australia.
4 School of Medicine, Sydney University, Australia.
5 Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
6 Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.
Conference/Journal: Psychooncology
Date published: 2021 Mar 3
Other: Special Notes: doi: 10.1002/pon.5671. , Word Count: 270

Cancer and its treatment can lead to a variety of physical and emotional concerns impacting on those affected, including subclinical or clinical depression and anxiety, which in turn have a significant impact on wellbeing, quality of life and survival. The aim of this review was to evaluate the effect of yoga-based interventions on self-reported depression and anxiety symptoms in people with cancer in randomized controlled trials.

Six databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta-analysis of suitable studies was conducted.

26 studies from our search criteria were eligible for inclusion for depressive and 16 for anxiety symptoms. Meta-analyses revealed evidence for significant medium effects of yoga on depression symptoms (N = 1,486, g = -0.419, 95% confidence interval [CI] = -0.558 to -0.281, p < 0.001) and anxiety (N = 977, g = -0.347, 95% CI = -0.473 to -0.221, p < 0.001) compared to controls. Subgroup analyses for depressive symptoms revealed significant effects for all analyses performed (type of cancer, type of control, treatment status, duration of intervention or frequency of yoga sessions), with effect sizes being comparable between subgroups. Similar findings were found for anxiety symptoms except for treatment status, where the only significant effect was found when yoga was delivered during active treatment.

This review provides evidence that in people with cancer, yoga-based interventions are associated with amelioration of depression and anxiety symptoms and therefore a promising therapeutic modality for their management. However, the potential for risk of bias together with control group design challenges means the results should be interpreted with caution.

Keywords: anxiety; cancer; depression; integrative oncology; psycho-oncology; supportive cancer care; survivorship; yoga.

PMID: 33763925 DOI: 10.1002/pon.5671