Randomized Controlled Trial on the Effect of Yoga on Anxiety Severity, Quality of Life, and Biomarkers in Individuals with Anxiety Disorder

Clinical Snapshot

Key Findings

• P Value: Reported as statistically significant for anxiety severity, quality-of-life physical/psychological/environmental domains, serum cortisol, and BDNF after Bonferroni correction; exact p-values not provided in abstract

• Effect Size: Not reported in the abstract; no Cohen's d, partial eta-squared, or mean difference values provided

• Primary Outcome: Anxiety severity measured by the Hamilton Anxiety Rating Scale showed significant Group × Time interaction, with improvement in the pranayama group but not the control group over 8 weeks

• Nnt Or Sensitivity: NNT not calculable from available data; no responder analysis or threshold-based outcome reported. Inflammatory and metabolic parameters showed directional trends only, not reaching statistical significance after correction

• Confidence Interval: Not reported in the abstract

Clinical Application

Slow pranayama and savasana are low-cost, low-equipment interventions that can be delivered in group or individual formats. The 8-week structured program is feasible in outpatient psychiatric settings. However, the 25% dropout rate suggests real-world adherence challenges that require further investigation. Instructor training, cultural acceptability, and patient motivation are implementation considerations. Yoga is widely practised in Australia and is increasingly integrated into complementary mental health care. However, slow pranayama as a structured clinical adjunct is not currently listed on the Medicare Benefits Schedule or recommended as a first-line or adjunct therapy in RACGP or Beyond Blue clinical guidelines for anxiety disorders. Referral to accredited yoga therapists or clinical psychologists with yoga training would be required for structured delivery. The TGA does not regulate yoga as a therapeutic intervention. PBS-listed pharmacotherapies (SSRIs, SNRIs, pregabalin) remain the pharmacological standard of care. This evidence, if replicated in higher-quality trials with Australian populations, could support integration into stepped-care models or as part of a broader lifestyle medicine approach endorsed by RACGP's Green Book. Practitioners should note the study's likely Indian cultural context when considering applicability to Australia's diverse patient population. Adults with diagnosed anxiety disorders (subtype unspecified) who are already engaged in routine psychiatric care and are willing and physically able to participate in supervised yoga breathing and relaxation practices

Abstract

Anxiety disorders are highly prevalent mental health conditions characterized by physiological dysregulation that includes heightened stress responses, low-grade systemic inflammation, and metabolic imbalance, which together contribute to impaired quality of life. Although yoga-based interventions are increasingly used as complementary therapies, evidence isolating the effects of slow pranayama (yoga breathing) and savasana (corpse pose) on psychological outcomes and biochemical markers in anxiety disorders remains limited. This randomized controlled study evaluated the effects of slow pranayama and savasana, implemented as adjuncts to routine psychiatric care, on anxiety severity, quality of life, and selected biochemical markers in individuals with anxiety disorders. A total of 150 people diagnosed with anxiety disorders were allocated to either routine psychiatric care alone (control group) or routine care plus slow pranayama and savasana (intervention group) for 8 weeks. We assessed anxiety severity using the Hamilton Anxiety Rating Scale, quality of life using the World Health Organization Quality of Life-Brief questionnaire, and biochemical markers such as serum cortisol, brain-derived neurotrophic factor (BDNF), inflammatory markers, and metabolic parameters. Outcomes were analyzed using mixed-design analysis of covariance with Bonferroni correction, and correlational analyses were performed between psychometric, quality-of-life, and biochemical variables. Of the enrolled participants, 112 completed the study. Significant Group × Time interactions were observed for anxiety severity scores and the physical, psychological, and environmental domains of quality of life, with improvements noted only in the pranayama group. Serum cortisol levels decreased and BDNF levels increased significantly in the intervention group compared with controls. Inflammatory and metabolic parameters did not show statistically significant changes after correction, although favorable directional trends were observed. Anxiety severity and quality-of-life scores demonstrated significant correlations with cortisol, BDNF, and inflammatory and metabolic markers. Slow pranayama and savasana appear to be safe, feasible, and effective adjuncts to standard psychiatric care, improving anxiety severity and quality of life while favorably modulating stress-related physiological markers in people with anxiety disorders.

References

1. 1.Natarajan, K., Pal, P., Pal, G. K., Bharadwaj, B., & Nanda, N. (2026). Randomized controlled trial on the effect of yoga on anxiety severity, quality of life, and biomarkers in individuals with anxiety disorder. International Journal of Yoga Therapy. https://doi.org/10.17761/2026-D-24-00087