Peer-Reviewed Research Review: The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis
Introduction
The article "The Neurophysiological and Psychological Mechanisms of Qigong as a Treatment for Depression: A Systematic Review and Meta-Analysis" by Wendy Wing Yan So, Shuhe Cai, Suk Yu Yau, and Hector Wing Hong Tsang aims to systematically review and meta-analyze the existing literature on the mechanisms through which Qigong exerts its anti-depressive effects. Qigong, an ancient Chinese practice involving physical movement, breathing techniques, and meditation, has been increasingly recognized for its potential mental health benefits, particularly in alleviating depression.
Methods
The authors adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. They conducted a comprehensive search of multiple databases, including PsycINFO, PubMed, Embase, ScienceDirect, and Academic Search Premier, from their inception until December 2018. The inclusion criteria were randomized controlled trials (RCTs) that investigated Qigong's impact on depression and its neurophysiological or psychological mechanisms. A rigorous process involving two independent raters was employed to select and evaluate the studies.
Results
The review identified nine studies that met the inclusion criteria, out of which seven were included in the meta-analysis. The studies varied in their sample sizes, ranging from 24 to 116 participants, and included both healthy subjects and patients with depression or other conditions. The types of Qigong interventions also varied, with different studies employing protocols such as Eight Section Brocades, Tai Chi, and Laughing Qigong, among others.
Effect on Depression: The meta-analysis revealed a small to medium significant effect of Qigong in alleviating depression (standardized mean difference, SMD = −0.27, p < 0.05, I2 = 27%). The studies utilized various self-reported depression scales, including the Geriatric Depression Scale and the Center for Epidemiologic Studies Depression Scale.
Neurophysiological Mechanisms:
Hypothalamic–Pituitary–Adrenal (HPA) Axis:
The studies on cortisol levels, a marker of HPA axis activity, yielded mixed results. Some studies reported significant reductions in cortisol levels in the Qigong group, while others found no significant differences.
Autonomic Nervous System:
Blood pressure measurements indicated a significant effect of Qigong on reducing diastolic blood pressure (SMD = −1.64, p < 0.05, I2 = 31%), although the effect on systolic blood pressure was not significant.
Psychological Mechanisms:
Self-Efficacy and Self-Concept:
One study highlighted significant improvements in self-efficacy and certain aspects of self-concept among participants practicing Qigong. These psychological improvements were correlated with reductions in depression.
Immune System:
C-Reactive Protein (CRP) and Immunoglobulin A (IgA):
Some studies reported significant reductions in CRP levels and increases in IgA levels, suggesting that Qigong might enhance immune function, which could be linked to its anti-depressive effects.
Discussion
The review concludes that Qigong has a beneficial effect on depression, primarily through the activation of the parasympathetic nervous system, as evidenced by its impact on diastolic blood pressure. However, the mechanisms related to the HPA axis and immune function require further investigation. The variability in the types of Qigong practiced and the outcome measures used across studies poses challenges for drawing definitive conclusions.
The authors acknowledge the limitations of the included studies, such as the high risk of performance bias and the small number of RCTs. They recommend that future research should focus on higher-quality RCTs, explore the neurological mechanisms of Qigong using advanced imaging techniques, and investigate the effects of different types of Qigong on depression.
Conclusion
This systematic review and meta-analysis provide evidence that Qigong can effectively reduce depressive symptoms, primarily through neurophysiological mechanisms involving the autonomic nervous system. The findings support the potential of Qigong as a low-cost, side-effect-free adjunctive treatment for depression. Further research is needed to confirm the underlying mechanisms and to explore the broader applications of Qigong in mental health care.
Reference:
So, W. W. Y., Cai, S., Yau, S. Y., & Tsang, H. W. H. (2019). The neurophysiological and psychological mechanisms of Qigong as a treatment for depression: A systematic review and meta-analysis. Frontiers in Psychiatry, 10, 820.
For more information on how practices like Qigong and meditation influence mental and physical health, please head over to www.jadedragon.org.
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