PMID- 37139325
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230505
IS  - 1664-0640 (Print)
IS  - 1664-0640 (Electronic)
IS  - 1664-0640 (Linking)
VI  - 14
DP  - 2023
TI  - The integration of yoga breathing techniques in cognitive behavioral therapy for 
      post-traumatic stress disorder: A pragmatic randomized controlled trial.
PG  - 1101046
LID - 10.3389/fpsyt.2023.1101046 [doi]
LID - 1101046
AB  - INTRODUCTION: In trauma-focused Cognitive Behavioral Therapy (TF-CBT), 
      stabilization techniques are used before confrontation ones to increase 
      stress/affect tolerance and thus effectiveness of CBT. This study investigated 
      the effects of pranayama, meditative yoga breathing and breath holding 
      techniques, as a complimentary stabilization technique in patients with 
      post-traumatic stress disorder (PTSD). METHODS: Seventy-four PTSD-patients (84% 
      female, 44.2 +/- 13 years) were randomized to receive either pranayama at the 
      beginning of each TF-CBT session or TF-CBT alone. The primary outcome was 
      self-reported PTSD severity after 10 sessions of TF-CBT. Secondary outcomes 
      included quality of life, social participation, anxiety, depression, distress 
      tolerance, emotion regulation, body awareness, breath-holding duration, acute 
      emotional reaction to stress, and adverse events (AEs). Intention-to-treat (ITT) 
      and exploratory per-protocol (PP) analyses of covariance with 95% confidence 
      intervals (CI) were performed. RESULTS: ITT analyses revealed no significant 
      differences on primary or secondary outcomes, except for breath-holding duration 
      in favor of pranayama-assisted TF-CBT (20.81 s, 95%CI = 13.05|28.60). PP analyses 
      of 31 patients without AEs during pranayama revealed significantly lower PTSD 
      severity (-5.41, 95%CI = -10.17|-0.64) and higher mental quality of life (4.89, 
      95%CI = 1.38|8.41) than controls. In contrast, patients with AEs during pranayama 
      breath holding reported significantly higher PTSD severity (12.39, 
      95%CI = 5.08|19.71) than controls. Concurrent somatoform disorders were found to 
      be a significant moderator of change in PTSD severity (p = 0.029). CONCLUSION: In 
      PTSD patients without concurrent somatoform disorders, the integration of 
      pranayama into TF-CBT might reduce post-traumatic symptoms and increase mental 
      quality of life more efficiently than TF-CBT alone. The results remain 
      preliminary until they can be replicated by ITT analyses. CLINICAL TRIAL 
      REGISTRATION: ClinicalTrials.gov, identifier NCT03748121.
CI  - Copyright (c) 2023 Haller, Mitzinger and Cramer.
FAU - Haller, Heidemarie
AU  - Haller H
AD  - Center for Integrative Medicine and Planetary Health, University Hospital Essen, 
      University of Duisburg-Essen, Essen, Germany.
FAU - Mitzinger, Dietmar
AU  - Mitzinger D
AD  - Center for Integrative Medicine and Planetary Health, University Hospital Essen, 
      University of Duisburg-Essen, Essen, Germany.
FAU - Cramer, Holger
AU  - Cramer H
AD  - Insititute of General Practice and Interprofessional Care, University Hospital 
      Tubingen, Tubingen, Germany.
AD  - Bosch Health Campus, Stuttgart, Germany.
LA  - eng
SI  - ClinicalTrials.gov/NCT03748121
PT  - Journal Article
DEP - 20230417
PL  - Switzerland
TA  - Front Psychiatry
JT  - Frontiers in psychiatry
JID - 101545006
PMC - PMC10150115
OTO - NOTNLM
OT  - cbt
OT  - cognitive behavioral therapy
OT  - mental disorder (disease)
OT  - post-traumatic stress disorder
OT  - pranayama
OT  - randomized controlled trial
OT  - safety
OT  - yoga
COIS- DM was the founder of the intervention and has financial relationships with 
      commercial interests. The remaining authors declare that the research was 
      conducted in the absence of any commercial or financial relationships that could 
      be construed as a potential conflict of interest.
EDAT- 2023/05/04 06:42
MHDA- 2023/05/04 06:43
PMCR- 2023/04/17
CRDT- 2023/05/04 02:16
PHST- 2022/11/17 00:00 [received]
PHST- 2023/03/22 00:00 [accepted]
PHST- 2023/05/04 06:43 [medline]
PHST- 2023/05/04 06:42 [pubmed]
PHST- 2023/05/04 02:16 [entrez]
PHST- 2023/04/17 00:00 [pmc-release]
AID - 10.3389/fpsyt.2023.1101046 [doi]
PST - epublish
SO  - Front Psychiatry. 2023 Apr 17;14:1101046. doi: 10.3389/fpsyt.2023.1101046. 
      eCollection 2023.