Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout.
Study Goal
The researchers aimed to compare the effects of traditional yoga (TY), mindfulness-based cognitive therapy (MBCT), and cognitive behavioral therapy (CBT) on health-related quality of life (HRQoL) in patients on sick leave due to burnout.
Results Summary
The study found that TY, MBCT, and CBT all improved HRQoL in key burnout-affected domains (e.g., emotional well-being, physical well-being, cognitive function, and sleep), with no significant differences between treatments. Effect sizes were mainly medium or large, with slight advantages for TY and MBCT over CBT in some subscales.
Population
Primary healthcare patients aged 18-65 in Stockholm, Sweden, on 50%-100% sick leave due to burnout.
Effective Dosage
Group treatment for 3 hours per week plus 4 hours of homework weekly.
Duration
20 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
traditional yoga (TY) | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | Ten subscales showed improvements | showed improvements | #1 |
mindfulness based cognitive therapy (MBCT) | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | seven subscales showed improvements | showed improvements | #2 |
cognitive behavioral therapy (CBT) | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | seven subscales showed improvements | showed improvements | #3 |
traditional yoga (TY) | increase | emotional well-being | patients on sick leave because of burnout | median improvement ranged from 0 to 27 points | improvements | #4 |
traditional yoga (TY) | increase | physical well-being | patients on sick leave because of burnout | median improvement ranged from 0 to 27 points | improvements | #5 |
traditional yoga (TY) | increase | cognitive function | patients on sick leave because of burnout | median improvement ranged from 0 to 27 points | improvements | #6 |
traditional yoga (TY) | increase | sleep | patients on sick leave because of burnout | median improvement ranged from 0 to 27 points | improvements | #7 |
cognitive behavioral therapy (CBT) | increase | emotional well-being | patients on sick leave because of burnout | median improvement ranged from 4 to 25 points | improvements | #8 |
cognitive behavioral therapy (CBT) | increase | physical well-being | patients on sick leave because of burnout | median improvement ranged from 4 to 25 points | improvements | #9 |
cognitive behavioral therapy (CBT) | increase | cognitive function | patients on sick leave because of burnout | median improvement ranged from 4 to 25 points | improvements | #10 |
cognitive behavioral therapy (CBT) | increase | sleep | patients on sick leave because of burnout | median improvement ranged from 4 to 25 points | improvements | #11 |
mindfulness based cognitive therapy (MBCT) | increase | emotional well-being | patients on sick leave because of burnout | median improvement ranged from 0 to 25 points | improvements | #12 |
mindfulness based cognitive therapy (MBCT) | increase | physical well-being | patients on sick leave because of burnout | median improvement ranged from 0 to 25 points | improvements | #13 |
mindfulness based cognitive therapy (MBCT) | increase | cognitive function | patients on sick leave because of burnout | median improvement ranged from 0 to 25 points | improvements | #14 |
mindfulness based cognitive therapy (MBCT) | increase | sleep | patients on sick leave because of burnout | median improvement ranged from 0 to 25 points | improvements | #15 |
traditional yoga (TY) | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | small effect size compared to CBT | better effect | #16 |
mindfulness based cognitive therapy (MBCT) | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | small effect size compared to CBT | better effect | #17 |
traditional yoga (TY) | increase | two subscales | patients on sick leave because of burnout | small effect size compared to MBCT | better effect | #18 |
mindfulness based cognitive therapy (MBCT) | increase | two subscales | patients on sick leave because of burnout | small effect size compared to TY | better effect | #19 |
20 week group treatment with TY, CBT or MBCT | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | - | had equal effects | #20 |
TY, MBCT and CBT | increase | HRQoL (health related quality of life) | patients on sick leave because of burnout | - | can be used to improve | #21 |
TY, MBCT and CBT | decrease | future morbidity | patients on sick leave because of burnout | - | reducing the risk | #22 |
BACKGROUND: To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout. METHODS: Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D. RESULTS: Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each. CONCLUSIONS: A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity. TRIAL REGISTRATION: July 22, 2012, retrospectively registered. ClinicalTrails.gov NCT01168661 . FUNDING: Stockholm County Council, grant 2003-5.