Pitt study finds benefits of yoga for people with schizophrenia

Medication has helped Mike Baldrige manage his schizophrenia, but yoga has brought him peace of mind.

Schizophrenia — a mental illness characterized by disorganized thoughts and movements — is typically treated through a combination of therapy, medication, psychosocial treatments and a range of other activities, depending on the person’s symptoms.

At the suggestion of his counselor two years ago, Baldrige, 64, from McKees Rocks, added an alternative method of treatment to his routine. He began participating in the Western Psychiatric Institute and Clinic outpatient yoga class — which ran from 2005 to 2015 — as a way to manage stress. The yoga, he said, has helped improve his attention, concentration and problem-solving skills.

“It definitely made me relaxed,” Baldrige said. “And when you have mental health symptoms, you need to relax.”

Researchers at Pitt and New Delhi doubt that Baldrige is the only person with schizophrenia to benefit from the practice of yoga. Last month, researchers from WPIC and the Ram Manohar Lohia Hospital in New Delhi published a randomized clinical trial showing that three weeks of simplified yoga training six days a week improved attention in schizophrenic patients.

Funded by the National Institutes of Health, the trial enrolled 300 schizophrenic patients into three randomized treatment groups: yoga, aerobic exercise and treatment as usual.

Study participants who learned yoga were faster on the attention-measuring portion of the test than those who did group aerobics or received only treatment as usual. In contrast, aerobic exercise improved accuracy on memory tasks. These effects lasted six months after the training period ended.

The trial, which was published in the journal Acta Neuropsychiatrica, was even more promising than the researchers originally expected, according to Triptish Bhatia, the lead author and a postdoctoral researcher at New Delhi’s Ram Manohar Lohia Hospital.

“I never hoped that yoga would help that much,” Bhatia said.

Ten years prior to helping patients like Bhandari, Bhatia began thinking about how yoga may fill in the shortcomings of antipsychotic medication.

Her mentor at the time, Pitt psychiatry professor Vishwajit Nimgaonkar, was dismissive of the idea. He was skeptical of prior work showing the cognitive benefits of yoga in people without schizophrenia and didn’t think that people with schizophrenia would be able to do yoga.

“Schizophrenics have a reputation for being the least motivated mental illness group,” Bhatia said. “Complaints from families are always there that they can’t concentrate or they can’t do yoga.”

But he decided to let her go for it. The researchers ran a pilot study in 2006 and a randomized clinical trial in 2010.

According to the Diagnostic and Statistical Manual of Mental Disorders, schizophrenia can result in “positive” and “negative” symptoms.

“Positive symptoms” distort reality and include delusions and hallucinations, while “negative symptoms” include physical freezing and cognitive deficits.

Bhatia said that although drugs can manage the positive symptoms of schizophrenia, negative symptoms are rarely addressed.

“Cognition is the one part of schizophrenia [that] cannot be cured or managed with pharmacotherapy,” Bhatia said. “There are very few things that can help patients to improve their cognition.”

To assess the cognitive impact of yoga training, the researchers used a suite of standard computerized tasks, adapted for use with Hindi speakers.

Memory tasks involved recalling a letter, face or shape presented earlier in a flashing stream.

The attention task involved flashing figures composed of up to seven line segments — like the numbers on a digital clock. The subject had to press a button when the line segments formed a letter or number.

As a participant in the clinical trial, 37-year-old Garima Bhandari said she found the clarity she needed to make plans for the future. Bhandari has continued to do yoga on her own about three times per week because, she said, it helps with her daily routine.

“All the distractions that used to happen around [me, I] found [myself] better able to cope with that, and [I] was able to concentrate better,” Bhandari, from New Delhi, said through a translator.

Bolstered by these positive results, Nimgaonkar is working with colleagues at WPIC to bring back the yoga class with a replacement instructor — the previous teacher returned to India — as a standard component of schizophrenia treatment. Ultimately, Nimgaonkar wants to do a clinical trial with people at WPIC.

Through his research, Nimgaonkar began to pick up the practice himself.

“I do yoga now,” he said. “I’ve become a regular proponent.”