Research AppraisalRandomised Controlled Trial

The stress reduction potential of Bhagavad Gita and Yoga for healthcare workers during the COVID-19 pandemic: A randomized controlled trial

PloS oneDas, Nishant, Konduru, Laalithya, Dahia, Simranjeet Singh et al.DOI

Clinical Snapshot

55CEBM
Evidence: WeakRandomised Controlled Trial

PICO Framework

P — PopulationHealthcare workers (>18 years) without pre-existing diagnosed mental health conditions at a secondary hospital in India during COVID-19 pandemic
I — InterventionYoga (60-min daily), Bhagavad Gita learning (60-min daily), or combined Yoga+Gita (30-min each daily) for one week
C — ComparatorUsual care control group
O — OutcomesPsychological distress measured by GAD-7 scale at baseline, immediately post-intervention, and 45 days post-intervention

Bottom Line

This small Indian RCT suggests that brief yoga and Bhagavad Gita interventions may reduce anxiety in healthcare workers, with the Gita showing more durable effects at 45 days. However, the study has significant methodological limitations including lack of blinding, small sample size, and narrow outcome assessment. The cultural specificity of the Bhagavad Gita intervention limits generalizability to diverse healthcare settings. While the interventions appear safe and potentially beneficial, larger, more rigorous trials with broader outcome measures are needed before recommending implementation. The findings support exploring culturally appropriate mind-body interventions for healthcare worker wellbeing, but evidence remains preliminary.

Evidence: Weak

Key Findings

  • P Value: Yoga+Gita vs Control immediately: p = 0.009; Gita vs Control at 45 days: p = 0.047

  • Effect Size: Clinically meaningful reduction (≥4-point GAD-7) in 47.1% (Gita) vs 11.8% (Control) at 45 days

  • Primary Outcome: GAD-7 anxiety scores at baseline, immediately post-intervention, and 45 days post-intervention

  • Nnt Or Sensitivity: Number needed to treat approximately 3 for Gita intervention based on clinically meaningful response rates

  • Confidence Interval: Not reported

Clinical Application

Requires trained instructors and dedicated time; one-week intensive format may be challenging in busy healthcare settings Limited direct applicability due to cultural specificity of Bhagavad Gita component; yoga elements may be more universally applicable. Would need adaptation for Australian healthcare workforce diversity Healthcare workers in high-stress environments, particularly those from cultural backgrounds where yoga and spiritual practices are accepted

Abstract

BACKGROUND: Healthcare workers (HCWs) experienced elevated psychological distress during the COVID-19 pandemic. Culturally embedded, non-stigmatizing approaches may improve uptake of mental health support in this population. We aimed to evaluate the impact of Yoga, Bhagavad Gita learning, and their combination (Yoga+Gita) on psychological distress among HCWs. METHODS: We conducted a prospective, single-center, parallel-group randomized controlled trial at a secondary hospital in India. Eligible HCWs (>18 years, without pre-existing diagnosed mental health conditions) were randomized in a 1:1:1:1 ratio to: Yoga (daily 60-min sessions for one week), Gita (daily 60-min teaching of Bhagavad Gita Chapter 2 for one week), Yoga+Gita (30 min Yoga + 30 min Gita daily for one week), or Control (usual care). Psychological distress was assessed using the Generalized Anxiety Disorder-7 (GAD7) scale at baseline (B-GAD7), immediately post-intervention (IPI-GAD7), and 45 days post-intervention (DPI-GAD7). Participants were aware of group assignment, but data analysts were blinded. Group comparisons used Friedman and Kruskal-Wallis tests with Bonferroni-adjusted post-hoc analyses. We hypothesized that (1) all three interventions would reduce GAD-7 scores compared with control, (2) Gita would produce more durable effects than Yoga alone, and (3) the combined Yoga+Gita intervention would yield the greatest overall reduction in psychological distress. FINDINGS: Sixty-eight participants were enrolled (17 per group), with no losses to follow-up. B-GAD7 did not differ across groups (p = 0.908). Compared with Control, Yoga+Gita reduced anxiety immediately (p = 0.009), and Gita reduced anxiety at 45 days (p = 0.047). A clinically meaningful (≥4-point) GAD7 reduction at 45 days occurred in 17.6% (Yoga), 47.1% (Gita), 41.2% (Yoga+Gita), and 11.8% (Control) of the participants. Exploratory analyses suggested larger benefits among women and among those who continued practice. INTERPRETATION: Yoga and Gita-learning, particularly in combination, were associated with reductions in psychological distress among HCWs. TRIAL REGISTRATION: Prospectively registered with the CTRI (CTRI/2021/10/037365).

References

  1. 1.Das, N., Konduru, L., Dahia, S. S., Sagnika, S., Kothari-Speakman, G., & Behura, A. K. (2026). The stress reduction potential of Bhagavad Gita and Yoga for healthcare workers during the COVID-19 pandemic: A randomized controlled trial. PLoS One. https://doi.org/10.1371/journal.pone.0347320
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