Breathing Focused Yoga in Social Anxiety Disorder
Condition: Social Anxiety Disorder
MeSH terms: Anxiety Disorders; Phobia, Social
Study type: Interventional

Summary: 
      The goal of this study is to determine the safety and effectiveness of Breathing Focused Yoga
      (BFY) in improving symptoms of social anxiety disorder (SAD). Patients with SAD will be
      randomized to 8 weeks of yoga or 8 weeks of wait-list. Symptom severity and quality of life
      will be compared between the two groups before and after the 8 weeks.
    

Detailed description: 
      This is an exploratory 8-week study with a randomized controlled, parallel group design, and
      will be carried out in two phases: 1) 8-week treatment phase and 2) a 3-month follow-up
      phase.

      60 patients meeting Diagnostic and Statistical Manual IV Text Revision, (DSM-IV-TR),
      diagnostic criteria for social anxiety disorder will be recruited. Patients who have provided
      written consent, have met study criteria, and are stabilized on pharmacotherapy will be
      enrolled into the study.

      In the treatment phase, patients will be randomized, to one of two groups 1) Breathing
      Focused Yoga (BFY); or 2) wait-list group.

      A sub-set of 15 drug- naïve patients and matched healthy controls will undergo functional
      magnetic resonance imaging (fMRI) scans before and after yoga treatment.

      A blood sample for genetic analysis will be taken from all SAD patients, to investigate to
      presence of genes linked to SAD and t treatment response.

      The primary aim of the study is to determine the safety and effectiveness of Breathing
      Focused Yoga (BFY) in improving symptoms of SAD.

      There are two secondary aims:

        1. To enhance the limited research data on the effect of treatment on neural circuitry in
           SAD, the investigators will also conduct fMRI scans on SAD patients and matched healthy
           controls pre- and post-BFY intervention.

        2. As well, to add to the literature on the genetics of SAD, the investigators will
           validate the links between specific gene polymorphisms and SAD that are already
           identified in the literature, and evaluate if they predict treatment response following
           BFY intervention.

      Primary Hypotheses

        1. Subjects with Social Anxiety Disorder will show significant improvement in symptoms
           after BFY, compared to the wait-list group.

        2. Improvement in quality of life scores will be significantly greater in the BFY group
           compared to the wait-list group.

      Secondary Hypotheses

        1. At baseline, the fMRI indications of neural circuitry of SAD subjects will differ from
           that of healthy controls.

        2. After yoga treatment, the fMRI indications of neural circuitry of treatment responders
           in the SAD group will be similar to that of healthy controls.

        3. The presence of specific gene polymorphisms in SAD patients will predict treatment
           response.
    

Intervention name(s): Yoga Treatment Group
Intervention type(s): Behavioral
Intervention description(s): The breathing focused yoga intervention is a manualized yoga protocol developed at CAMH by the Mood and Anxiety Disorders group, with yoga teacher, Ms. Tiffany Garfinkel, as the lead. BFY incorporates postures and meditation, but there is a special focus on controlled breathing at different rates, including Ujjaji or slow inhalation, exhalation and holding of breath; Bhastrika or Kapalabhati, two types of vigorous breathing with forced exhalation; and cyclical breathing or a repeated pattern of slow, moderate and fast breathing.
Other intervention name(s): Breathing Focused Yoga
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Social Anxiety; Yoga