Доклад от Йога конгреса с международно участие – София, 2013г.

Summary
Treatment for most psychiatric disorders, such as major depression, bipolar depression and anxiety disorders, usually consists of a combination of pharmacotherapy and psychotherapy. Although these treatments are effective, the effects usually are moderate, meaning that many people with psychiatric disorders do not fully recover with these treatments. Also, many people suffer from side-effects of prescribed medication. Therefore it is important to continue to seek for new and better treatment options for psychiatric disorders. In recent years yoga has been used more and more as an intervention for patients with psychiatric problems and the effects have been studied. So far, yoga has shown a positive effect on depression, anxiety disorders, post-traumatic stress disorder and schizophrenia. In this
lecture the current evidence for yoga for psychiatric disorders is shown and the preparations of a yoga intervention and study for patients with a broad range of psychiatric disorders at an outpatient center for psychiatric disorders are presented.

Author and Center
Nina K. Vollbehr is a psychologist, researcher and yoga teacher at the Center for Integrative Psychiatry (CIP). This center is part of Lentis, a large mental health care institution in the northern part of the Netherlands. The CIP serves about 500 adult outpatients a year.
Patients of the CIP suffer from a large variety of psychiatric disorders, most common are mood disorders (36%) and anxiety disorders (15%) as well as personality disorders (34% of the patients). Patients usually have a long history of illness (median of 11). The mean
treatment duration at the CIP is 288-388 days.
At the CIP patients are treated with conventional therapies (medication, cognitive behavioural therapy, EMDR, psychotherapy and counselling by specialized nurses), lifestyle training (diet, exercise, relaxation, communication, and heart rate variability training),
mindfulness-based cognitive therapy (MBCT), and a selection of evidence-based complementary medicines such as Saint John’s Wort, omega-3 fatty acids, SAMe and methylfolate. The CIP follows the principles of stepped care and applies a protocol with an algorithm to guide clinical decision making (Hoenders et al., 2011).

Introduction
Treatment for most psychiatric disorders, like major depression, bipolar depression and anxiety disorders, usually consists of a combination of pharmacotherapy and psychotherapy (Van Balkom et al., 2012; Spijker et al., 2012). Although these treatments certainly are effective, the effects usually are moderate, meaning that many people with psychiatrics disorders do not fully recover with current treatments. Response rates for both pharmacotherapy and psychotherapy are usually between 50-65% (Unduragga, 2012; DeRubeis, 2008; Van Balkom et al., 2012; Baldwin, 2005). Also, many people suffer from side-effects of medication. Therefore it is important to continue seeking new and better treatment possibilities for psychiatric disorders.
Originally, yoga emerged in India and was developed as a system of philosophy, meditation and physical exercise. For thousands of years yoga was used to systematically study and explain the human mind and the human condition (Becker, 2000). The goal of the yoga practices is the ‘development of a state of mental and physical health, well-being, inner harmony (…)’ (Khalsa, 2004, p.269).
The introduction of yoga in the West began with the presentation of Swami Vivekananda in front of the World Parliament of Religions in Chicago in 1893. In 1919 the physical form of yoga, called Hatha yoga, was presented to the Americans by Yogendra Mastamani (Becker, 2000). In the following years yoga spread more and more in the Western world. It is estimated by a survey of Yoga Journal in 2012 that 8.7% of the American adults use yoga (Yoga Journal, 2013).

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