A 12-week program of instruction and practice of the Chinese martial art tai chi led to significantly reduced symptoms of depression in Chinese Americans not receiving any other treatments. The pilot study conducted by investigators at Massachusetts General Hospital (MGH) and published in the Journal of Clinical Psychiatry enrolled members of Boston's Chinese community who had mild to moderate depression.
"While some previous studies have suggested that tai chi may be useful in treating anxiety and depression, most have used it as a supplement to treatment for others medical conditions, rather than patients with depression," explains Albert Yeung, MD, ScD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, lead and corresponding author of the report. "Finding that tai chi can be effective is particularly significant because it is culturally accepted by this group of patients who tend to avoid conventional psychiatric treatment."
Participants were recruited through advertisements offering tai chi for stress reduction, and their eligibility for the study was determined based on in-person interviews and assessments of overall health and depression symptoms. Eligible participants were Chinese-American adults fluent in either Cantonese or Mandarin, with a diagnosis of major depressive disorder in the mild to moderate range, no history of other psychiatric disorders, no recent practice of tai chi or other mind-body interventions, and no current use of other psychiatric treatments.
Participants were randomized into three groups - one that received the tai chi intervention; an active control group that participated in educational sessions that included discussions on stress, mental health and depression; and a passive control, "waitlist" group that returned for repeat assessments during and after the study period. The tai chi intervention involved twice weekly sessions for 12 weeks, in which participants were taught and practiced basic traditional tai chi movements. They were asked to practice at home three times a week and to document their practice. The education group also met twice weekly for 12 weeks, and sessions for both groups were offered in Cantonese or Mandarin. Members of both the education and waitlist groups were able to join free tai chi classes after the initial study period, something they were informed of at the study's outset.
Of the 50 participants who completed the 12-week intervention period, 17 were in the tai chi group, 14 in the education group and 19 in the waitlist group. The 12-week assessments showed that the tai chi group had significantly greater improvement in depression symptoms than did members of either control group. Follow-up assessment at 24 weeks showed sustained improvement among the tai chi group, with statistically significant differences remaining compared with the waitlist group.
"If these findings are confirmed in larger studies at other sites, that would indicate that tai chi could be a primary depression treatment for Chinese and Chinese American patients, who rarely take advantage of mental health services, and may also help address the shortage of mental health practitioners," says Yeung, who is an associate professor of Psychiatry at Harvard Medical School. "We also should investigate whether tai chi can have similar results for individuals from other racial and ethnic groups and determine which of the many components of tai chi might be responsible for these beneficial effects."
The co-authors of the Journal of Clinical Psychiatry paper are Run Feng, MPH, Daniel Ju Hyung Kim, Lee Baer, PhD, Jonathan Alpert, MD, PhD, and senior author Maurizio Fava, MD, MGH Department of Psychiatry; John Denninger, MD, PhD, Herbert Benson, MD, and Gregory Fricchione, MD, Benson Henry Institute for Mind Body Medicine at MGH; Peter Wayne, PhD, and Gloria Yeh, MD, MPH, Osher Center for Integrative Medicine, Brigham and Women's Hospital; and Othelia Lee, PhD, University of North Carolina. The study was supported by National Center for Complementary and Integrative Health grant R2 1AT006123.
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $800 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, genomic medicine, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, photomedicine and transplantation biology. The MGH topped the 2015 Nature Index list of health care organizations publishing in leading scientific journals and earned the prestigious 2015 Foster G. McGaw Prize for Excellence in Community Service. In August 2016 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of "America's Best Hospitals."