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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.

BMC complementary and alternative medicine
January 1, 1970
Astrid Grensman et al. (7 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

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

Extracted Claims (22)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
AdultAgedCognitive Behavioral TherapyEmotionsFemaleHumansMaleMiddle AgedMindfulnessOccupational StressQuality of LifeSick LeaveSurveys and QuestionnairesTreatment OutcomeYogaYoung Adult
Study Links
Quality Scores
SafetyNot Assessed
Efficacy80/10
Quality85/10
Citation Metrics
Total Citations32
Citations/Year4.6
Relative Citation Ratio2.64
NIH Percentile82.1%
Research Impact Scores
APT Score0.75
Weight Score1.87
Normalized Score0.69
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