The Effects of Yoga on Student Mental Health

Study Overview
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Brief Summary
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The investigators performed a randomised controlled trial with 202 healthy university students in the Oslo area, with 50:50 in a yoga intervention group and a waitlist control group. Measures included symptoms of depression and anxiety, sleep problems, heart rate variability (HRV), well-being and mindfulness at week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up).

Detailed Description
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Universities around the world are facing an epidemic of mental health problems among their students. The problem is truly a public health issue, affecting many and with serious consequences. Moreover, the global burden of disease-agenda calls for effective interventions with lasting effects that have the potential to improve the mental health of young adults. In this study the investigators aimed to determine whether yoga, a popular and widely available mind-body practice, can improve student mental health. The participants were randomly assigned to a yoga group or waitlist control group in a 1:1 ratio by a simple online randomisation program. The intervention group was offered 24 yoga sessions over 12 weeks. Measurements were taken at week 0 (baseline), week 12 (post-intervention), and week 24 (follow-up). The primary outcome was psychological distress assessed by the HSCL-25 questionnaire. Analysis was performed based on the intention to treat-principle. The methods were laid out in a protocol, previously published on the website of the study. (available at http://yogastudy.tilda.ws/). The planned analyses were very straightforward and included a description of the study participants, and simple analyses of each of the a priori selected outcome measures. We have not included or excluded any variables post-hoc.

Official Title
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The Effects of Yoga on Student Mental Health: A Randomised Controlled Trial

Conditions
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Mental Health, Public Health, Depression, Anxiety, Sleep Problem, University Students

Intervention / Treatment
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* Behavioral: Yoga group
* Behavioral: yoga course


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Living in the Oslo area Exclusion Criteria: No serious mental health diagnoses No recent major life crisis No systematic yoga practice during the prior six months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>The intervention group received a yoga course for 12 weeks, two times a week. Each yoga class was 1.25 hr in duration. | Behavioral: Yoga group<br>* The intervention group received yoga 2 times a week for 12 weeks (á 1.25 hr).<br>* Other names: Intervention group;|
| Active Comparator: Control group waitlist<br>The control group were on a waitlist during the period of measurements, and received the same yoga course after all measurements had been completed. | Behavioral: yoga course<br>* yoga course<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Psychological Distress | Measured with the Hopkins Symptom Checklist 25 (HSCL-25) questionnaire. Consists of 25 items on symptoms of depression and anxiety, each rated on a 1 (not at all) to 4 (very much) scale. Total scores range from 1 to 4, a higher score indicating more psychological distress. | Week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Heart Rate Variability (HRV) | Measured with nocturnal RMSSD (root mean square of successive differences), which is a validated measure of activity in the parasympathetic part of the autonomic nervous system. In general, an increase in RMSSD is associated with increased parasympathetic system activity and less distress. | Week 0 (baseline) and week 12 (post-intervention) | 
| Change in Mental Well-being | Measured with the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), a 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). This scale has five response categories (from not at all to all the time) that are added together to produce a total score ranging from 14 to 70. Higher scores indicate higher levels of mental well-being. | Week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up). | 
| Change in Life Satisfaction | Measured with the Satisfaction With Life Scale (SWLS), a 5-item questionnaire. Items are scored on a 1- to 7-point Likert scale. The total score is computed by adding all response values (ranging from 5 to 35), with higher scores indicating higher satisfaction. | week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up). | 
| Change in Mindfulness | Mindful Attention Awareness Scale, MAAS, a 15-item scale. The total score was computed by adding the score value on all individual items, producing a total score ranging from 15 to 75, with higher scores indicating higher levels of mindfulness. | Week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up). | 
| Change in Sleep Problems | The investigators used the Bergen Insomnia Scale (BIS), a 6-item scale. Scores from 0 (no bad nights during the course of a week) to 7 (all nights) give a total score ranging from 0 to 42 (higher scores indicating more troubled sleep and daytime tiredness). | Week 0 (baseline), week 12 (post-intervention) and week 24 (follow-up). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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depression, mental health, public health, anxiety, sleep problems, insomnia, yoga, students