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Research on Hindu beliefs/practices and mental health is growing, although is still in its infancy compared to research in Christians and Muslims. Nevertheless, a number of earlier and more recent studies have sought to objectively examine these connections. Presented in this chapter is a systematic review of studies on Hindus living in India and elsewhere in the world conducted prior to 2010 (Koenig et al., 2001; 2012). In the next chapter, a selection of more recent studies published between 2010 and 2016 will be discussed, and a recent analysis of data from international surveys on Hinduism and well-being will be presented.
Reviewed now is early research (up through 2010) on the role of the Hindu religion has played in coping with stress/trauma, and the relationships between religiosity/religious affiliation and coping with stress, anxiety and depression, suicide, psychosomatic symptoms, chronic mental disorder, and substance use/abuse. Studies that examine Hindu interventions to improve mental health will also be reviewed.
Coping with Stress
Dalal and Pande (1988) prospectively followed 41 patients coping with major physical injuries within the past week (21 permanently disabled). All participants were hospitalised in Allahabad, India, and most were from lower middle-class Hindu families. Participants were assessed on admission and 15 days later. When asked which among six factors was most likely to have caused the event, “God’s will” was rated the highest. When asked which among seven factors was most essential to recovery, more than half of both permanently and temporarily disabled patients indicated “God’s will.” When data across the two time points in the overall sample were merged, causal attributions for the accident to karma or “God’s will” were the two factors most strongly related to actual psychological recovery, especially in those who were permanently disabled (r=.43 and r=.48, respectively, on admission; r=0.29 and r=0.29 on follow-up; all p’s<0.10 in this small sample).
Rammohand and colleagues (2002) examined the role that religion played in the coping of 60 Hindu family caregivers of patients with schizophrenia. Family caregiver burden was assessed using the 40-item Burden Assessment Schedule of the Schizophrenia Research Foundation. Well-being was assessed with the 28-item Psychological Well-Being Scale (Bhogle and Jaiprakash). Strength of religious belief was assessed with a single item, and numerous other coping strategies were also measured. Controlling for caregiver burden, religious belief was the strongest predictor of psychological well-being (B=0.21, p=0.01) among all coping strategies.
In a case-control study involving 62 community-dwelling Indian adults, Anjana and Raju (2003) examined the effects of reciting the Bhagavad Gita on maladjustment, finding that those who recited the Gita were more likely to be adjusted. No further details are available (only abstract available, and journal out-of-print and not accessible).
Depression
Diwan et al (2004) conducted a telephone survey of 226 migrants age 50 years or older living in the Atlanta metropolitan area. All participants had migrated from India to the U.S. and 79% were Hindu. Demographics, chronic health problems, stressful life events, mastery, religiosity, and acculturation were assessed using standard measures. Religiosity was measured by a 5-item religiosity scale that assessed frequency of meditation, prayer, reading holy books, participating in spiritual discourses, and attending religious functions. Positive and negative affect (the primary dependent variables) were measured by an 8-item version of the CESD. Results indicated that while there was no relationship between religiosity and positive affect. However, there was an inverse relationship between religiosity and negative affect/depressive symptoms (z=-2.23, p=0.03), after controlling for individual characteristics (demographics, stressful life events, chronic health problems) and personal resources (social support, mastery, acculturation).
Using a newly developed 20-item measure of Hindu religious coping (Hindu RCOPE), Tarakeshwar and colleagues (2003) examined the relationship between religious coping and mental health (depressive symptoms, life satisfaction, marital satisfaction) in 164 Hindus living in different regions of the U.S. Depressive symptoms were assessed using the CESD; life satisfaction by the Satisfaction with Life Scale; and marital satisfaction by the Kansas Marital Satisfaction Goal. The Hindu RCOPE consists of three subscales: God-focused (seeing how God might be strengthening person, seeking God’s love and care, sticking to teachings and practices of religion, collaborating with God, etc.), spirituality-focused (psychophysical exercises such as yoga/meditation, seeking spiritual awakening, offering spiritual support, etc.), and negative religious coping (religious guilt, anger, and passivity). Controlling for demographic variables (age, marital status, income), the God-focused subscale was the only part of the Hindu RCOPE that was positively related to mental health (life satisfaction, B=0.34, p<.01), whereas the negative religious coping subscale (religious guilt/anger/passivity) was associated with lower life satisfaction (B=-.27, p<.01), greater depressed mood (B=0.40, p<.01), and lower marital satisfaction (B=-0.23, p<.05).
Suicide
Suicide rates can serve as a proxy for mental health, although cultural factors also play a role (i.e., suicide may be more permissible in certain religions, especially Eastern religious belief systems). The government of India published a report on suicide rate in 1964-1965, indicating a rate of 5.7-6.3/100,000, which was considerably lower than that for the United States (11.1/100,000) and many other countries at the time (Pandey, 1968). In explaining the results, Pandey argued that while Hindus do not believe that suicide brings eternal damnation, they do believe that the spirit of the person who committed suicide remains on the earth until the period of their granted lifetime ends and suffers pains more severe than a usual death would bring. After that period ends, it is believed that the person will be reborn into the same, higher, or lower “form” depending on past actions (karma), of which the act of the suicide is only one. Pandey explains how Hindus of the time understood suicide, based on the “theory of the gunas” (as described in chapters 3, 7, 13, 14, 17 and 18 of the Bhagavad Gita). The belief is that most suicides are committed when the Tamas guna has more sway over the person’s life than other gunas:
The theory of the gunas, which describes all human behaviour, is known by every Hindu. The gunas represent different stages in evolution in any particular eternity. They are also understood in terms of personal qualities endowed by the Almighty. Every person is born with some combination of the gunas. The relative dominance of the gunas may change in the course of a person’s life depending upon his action, committed either in this or a past life. The three gunas are Sattwa, Rajas, and Tamas. They come from Prakriti (the Cosmos) which is of eightfold composition: earth, water, fire, air, ether, mind, intellect, and ego. Sattwa has the element of sacrifice, and it is the light which makes men search for knowledge, wisdom, happiness, and contentment. Rajas has the element of greed, and it has a stimulating nature which makes individuals thirsty for pleasure, power, and possession. Tamas, the affecting factor which darkens the judgement of the doer, has the elements of delusion, sluggishness, and stupor… When sattwa prevails over Rajas and Tamas, the man is happy, contented, and understanding. When Rajas dominates over Sattwa and Tamas, the person feels lustful for power and possession, is very greedy and restless. If Tamas rules over the other two gunas, the person is lost in the dark, bewildered, slothful and deluded (pp 199-200).
Thus, when the Tamas gunas is strong in a person’s life, this state of darkness and delusion increases the risk for suicide.
Kamal and Lowenthal (2002) examined the relationship between religiosity and suicide beliefs/behaviours among 40 Hindus and 60 Muslims (mean age 22.5 years) living in the greater London area (UK). Religiosity was assessed by frequency of prayer, religious study, and attendance at worship services. Suicidal beliefs and behaviour were assessed using the 47-item Reasons for Living Inventory (RLI), which has six subscales assessing survival and coping, importance of family, importance of having children, fear of suicide, fear of social disapproval, and moral reasons. In addition frequency of suicidal thoughts, suicidal plans, and suicide attempts were also assessed. Results indicated that Muslims were significantly more likely than Hindus to endorse moral, survival/coping beliefs, and overall reasons for living. However, there were not significant differences between Muslims and Hindus on suicidal thoughts, plans or behaviour. Religious activity overall did not correlate with any RFL subscale (except the moral reasons subscale), and did not correlate with suicidal thoughts, plans or behaviour.
In contrast, a survey of adolescents in Delhi, India, found an increased risk of suicidal tendencies among Hindus (Sidhartha and Jena, 2006). These researchers surveyed 1205 adolescents ages 12 to 19 years attending two schools in central Delhi examining the prevalence and predictors of non-fatal suicidal behaviours (NFSB) across the lifetime and during the past year. Adolescents were 85% Hindu, 8% Muslim, 6% Jains, and 0.7% Christian. Results indicated that lifetime prevalence of suicidal ideation was 21.7% and past year suicidal ideation was 11.7%; prevalence of lifetime suicide attempt was 8% and past year suicide attempt was 3.5%. Significant predictors of NFSB were female gender, older age, history of physical abuse by parents, feeling neglected, running away from school, suicide by friend, death with, deliberate self-harm, and Hindu religion (OR=1.67, 95% CI 1.09-2.57).
The findings above conflict with those reported by Gururaj and colleagues (2004), who conducted a case-control study involving interviews with families of 269 persons who had completed suicides and 259 living controls from the same community (Bangalore). Cases and controls were matched on age and gender. The majority of suicides occurred between the ages of 16 and 39 (67%) and among those with relatively low education (84% with 10th grade or less). Lack of religious beliefs predicted a nearly 20-fold increase in likelihood of suicide (OR=19.2, p<0.001).
Anxiety and Fear
In an early study of religiosity and psychological symptoms in India, Hassan and Khalique (1981) surveyed a random sample of 480 college students in Ranchi and Jamshedpur, India, (160 Hindu males, 160 Hindu females, 160 Muslim males, 160 Muslim females), examining the relationship between religiosity, anxiety, authoritarianism, rigidity, and intolerance of ambiguity. a 10-item religiosity scale constructed by the investigators was administered, along with measures of authoritarianism, rigidity, intolerance of ambiguity, and anxiety (using standard scales of these constructs). results indicated that religiosity was higher among Muslims compared to Hindus (35.5 vs. 29.9, p=0.01), was not related to caste level (high vs. low), but was positively related to authoritarianism (r=0.34, p<.01), anxiety (r=0.46, p<.01), rigidity (r=0.48, p,.01), and intolerance of ambiguity (r=0.54, p<.01). Researchers concluded that “It may be that religiosity is a kind of defensive reaction against personality weakness” (p 134).
In what may be the first experimental study to examine the effects of religiosity on mental health in India, Dhawan and Sripat (1986) examined the effects of religiosity on fear of death in 100 undergraduate students, 40 of whom were divided into high (n=20) and low (n=20) religiosity groups based on the Bhushan’s religiosity scale (1970). Fear of death (assessed by Sinha’s Threat Perception Scale) was induced in half of subjects by exposing them to fear of death cards, thus creating four groups: 10 religious fear-exposed subjects (A), 10 non-religious fear-exposed subjects (B), 10 religious controls (C), and 10 non-religious controls (D). Need for affiliation with others (assessed by Murray’s TAT Card Test) in response fear of death was also assessed. Results indicated that fear of death and need for affiliation were significantly higher in the experimental groups (A and B) compared to controls (C and D), as expected. Religiosity, however, was not related to fear of death nor did it reduce fear of death or subsequent affiliation behaviour in the experimental group.
Guglani et al (2000) examined relationship between religiosity and mental health in 70 Hindu grandmothers (mean age 66.9 years) as part of a study of Asian families living in the United Kingdom (UK). Grandmothers had lived an average of 23.0 years in the UK. Religiosity was assessed using a 12-item Hindu religious participation scale that assessed level of devotion, frequency of religious attendance, and frequency of other organised religious activity. Mental health measures included the 14-item Hospital Anxiety and Depression Scale and the 10-item Rosenberg Self-Esteem Scale. Uncontrolled analyses indicated non significant relationship between religious participation and anxiety, depression, or self-esteem.
Somatic / Psychosomatic Symptoms
In one of the first studies to examine religion and mental health among Hindus, De Figueiredo and Lemkau (1978) surveyed a stratified random sample of adults in Goa, India, in 1973. Participants were 80 Christians and 80 Hindus of similar education, occupation and income. Among Hindus, 43% attended temple once/week or more compared to 46% of Christians who attended religious services more than once/week, while 65% of Hindus “often” engaged in private worship at home (prayer or scripture reading) compared to 50% of Christians. A 23-item measure of psychosomatic symptoms was used to assess sleep quality, mood, concentration, and other psychological and somatic symptoms. Results indicated that Christians and Hindus had a similar level of psychosomatic symptoms, but those with high religious attendance (vs. low) were significantly less likely to experience high levels of psychosomatic symptom. Among Christians, this was true for both men (2.5% vs. 15.0%, p=0.016) and women (2.5% vs. 32.5%, p=0.0002). Among Hindus, this was true for women (10.0% vs. 50.0%, p=0.001) but not for men (10.0% vs. 25.0%, p=0.24). For private religiousness, however, the pattern was reversed. Among Christians, high prayer and scripture reading (vs. low) were associated with high psychosomatic symptoms in both men (15.0% vs. 2.5%, p=0.007) and women (30.0% vs. 5.0%, p=0.0005). Among Hindus, this was true in men (30.0% vs. 2.5%, p=0.02) and a similar trend was present in women (40.0% vs. 20.0%, p=0.08). These findings provide a mixed picture on religiosity and psychosomatic symptoms.
Next, Chaturvedi and Bhandari (1989) examined illness behaviour patterns in 31 consecutively admitted psychiatric outpatients in Bangalore, India, who (1) volunteered a complaint of pain or other bodily symptom, (2) had organic pathology excluded by detailed physical exam, (3) had a duration of illness greater than 6 months, (4) were previously treated by a medical physician for their complaints, and (5) had more than two somatic symptoms for which no organic basis could be found. Results indicated that Hindus (n=24) were more likely to recall they were told they had physical illness compared with Muslims (n=7) (p<0004), and to believe that the cause of their psychiatric illness was physical in nature (p=0.03). Researchers concluded that Hindus were more likely to demonstrate “denial” and exhibit greater somatisation (believed they had physical causes for their psychiatric illness).
Although not strictly considered psychosomatic, eating disorders are conditions involving strong somatic preoccupation. Therefore, information about such conditions in Hindu may help to clarify the link with somatisation described by Chaturvedi and Bhandari (1989) above. In a study that assessed religion and eating disorders, Bhugra and colleagues (2000) found no association between the presence of bulimic symptoms (assessed using the 26-item BITE) and religious affiliation (87.9% Hindu, 9.5% Sikh, 0.8% Muslim) in a sample of 504 students at an all-girl college in northern India.
Patel and colleagues (2006) examined the relationship between religious affiliation and complaints of abnormal vaginal discharge (AVD) among a random sample of 2,094 community dwelling women ages 18-45 years living in the state of Goa, India (75% Hindu, 22% Christian, 3% Muslim). AVD is known to be a common psychosomatic complaint in this region of India. Somatic symptoms were assessed with a 20-item Scale for Somatic Symptoms, and mental health was determined by the Revised Clinical Interview Schedule. Participants were assessed at three periods T0 (baseline), T1 (six months), and T2 (12 months). The incidence of AVD during each of the two time periods (T0-T1 and T1-T2) was 3.6% and 4.0%. Factors associated with complaint of AVD in a multivariate model were younger age, illiteracy, concern that husband having extra-marital affairs, high somatic symptom scores, poor mental health, current bacterial vaginosis, and being Muslim (OR=3.2, CI 1.7-6.0) or Christian (OR=1.6, 95% CI 1.0-2.3), compared with being Hindu. Thus, Hindus had the lowest incidence of AVD. Also, see results of a Hindu-based intervention below showing a reduction in menopausal symptoms that may have a psychosomatic component (Chattha et al., 2008). Thus, there is only minimal evidence that Hindus express more psychosomatic symptoms than non-Hindus.
Schizophrenia
In the first known longitudinal study of religion and mental health in Hindus, Verghese and colleagues (1989) conducted a 2-year prospective study of 323 persons with schizophrenia ages 15-45 within two year of diagnosis seen at university psychiatric outpatient clinics in, Lucknow, Madras, and Vellore, India. Symptoms were assessed using the Present State Exam (a well-known structured psychiatric interview). Examined were factors associated with a good overall outcome at 2-year follow-up. Of the 10 factors associated with good overall outcome, an increase in religious activities was one (p<0.001). Investigators concluded that “If these associations are confirmed, it is possible to plan some intervention programs, such as changing the attitudes of others to the patients, and giving more importance to various types of religious activity. Religiosity is important in Indian culture and the increase in religiosity that was related to better outcome in the present study could be a means of effectively handling the anxiety of the patient” (p 502).
Thara and Eaton (1996) followed 76 patients with chronic schizophrenia in Madras, India, for 10 years examining predictors of clinical outcome. Outcomes were categorised into “good” or “poor,” where poor involved relapses and continuous illness. Diagnosis and outcomes were again based on the Present State Exam and clinical course. Although religious activity did not differ between the two outcomes, those with religious and grandiose delusions were over nine times more likely to be in the poor outcome group (adjusted OR=9.21, p<0.01). Unfortunately, religious and grandiose delusions were combined into a single category, making it difficult to determine if increased risk was due specifically to religious delusions or to grandiose delusions.
In a study that was largely qualitative, Kulhara et al (2000) examined religious attitudes towards illness and treatment in 40 patients with schizophrenia and relatives (70% Hindus, 26% Sikhs) attending a psychiatric outpatient clinic in Northern India. Although most patients had hallucinations (70%) and delusions (92%), only 10% had religious delusions. Of those with delusions, 38% express them in terms of paranormal phenomena. Patients’ relatives were asked about magical-religious beliefs as the cause of the mental illness. Over one-third (35%) attributed the illness to sorcery, 25% to ghost/evil spirits, 25% to spirit intrusion, 16% to evil spirits, and 12% to divine wrath. Nearly half of relatives (46%) indicated that such beliefs were prevalent in the community to which they belonged (these relatives were urban-dwelling and well-educated). One-third of relatives (33%) expressed the belief that performance of religious rituals (puja) or magical-religious rituals (Jhad-Phoonk) could improve the patient’s condition, 53% said they had consulted a faith healer or a priest, and 58% said that religious rituals had been performed during the present illness. Researchers concluded that belief in supernatural influences is common among relatives of patients with schizophrenia, even those from urban areas with fairly high education.
In one of the most remarkable studies published to date, investigators from the National Institute of Mental Health and Neurosciences, Bangalore, India, examined the effects of staying at a Hindu temple in 31 psychotic patients (23 paranoid schizophrenia, 6 delusional disorder, 2 bipolar disorder in manic phase) (Raguram et al., 2002). No participants received medical care from a psychiatrist either prior to or during the stay at the temple. The temple was located in the village of Velayuthampalayampudur, Dindugal District, Tamil Nadu, and was built over the tomb of a mentally ill person said to have had healing powers (for mental illnesses in particular). Families for years had brought their mentally ill relatives to stay in the temple and took care of their daily needs. During their temple stay, the mentally ill were encouraged to take part in the daily routines of the temple, such as cleaning the compound, watering the plants, and other maintenance activities. Consecutive patients who came to the temple for help over a 3-month period were studied. The Brief Psychiatric Rating Scale (BPRS), which assesses 18 psychiatric symptoms, was administered by a psychiatrist on admission to the temple and just prior to leaving the temple. Average length of stay was six weeks (range 1-24 weeks). Outcomes were clinical symptoms on BPRS and perceived benefit reported by family members. Results indicated a 20% drop in BPRS score from 52.9 on admission to 42.9 on departure (p<0.001). According to subjective evaluation by family caregivers, 22 subjects (71%) had improved and three had fully recovered. Investigators noted that a 20% change in the BPRS (as noted with these patients) is similar to that seen with psychotropic drugs, including newer atypical antipsychotics.
Drug Use/Abuse
Dube and colleagues (1975) examined cannabis use an religious affiliation among all male first admissions to a psychiatric hospital in Agra, India (n=566). Hindus were more likely to be cannabis users than were Muslims (25.8% vs. 3.8%). This was particularly true among the Kshatriyas warrior caste (30.6%) and only slightly lower (24.0%) among the Brahmin caste (priests and nobles). The next study examined opium use in a random sample of 2,064 men and 1,536 women age 15 or over in Punjab, India (Mohan et al., 1979). Among men, religious affiliation was a significant predictor of opium use, with Sikhs more likely to use opium than Hindus, and Hindus more likely to use opium than other religious groups (11.7% vs. 5.3% vs. 1.9%, p<.001, respectively).
Chaturvedi and colleagues (2003) surveyed a random sample of 1,831 community-dwelling persons ages 10 and above (mean age 30.2 years) from two selected states in Northeast India. Participants were 77% Hindu, 21% Christian, and 2% Muslim. Tobacco use by religion was 42.8% among Christians (21.5% chewers and 22.8% smokers) and 25.9% among Hindus (20.4% chewers and 9.9% smokers). Christians were more likely to be cigarette smokers (22.8%) then were Muslims (14.8%) or Hindus (9.9%).
Alcohol Use/Abuse
Chaturvedi et al (2003) found no differences in use of alcohol between Christian, Muslim, and Hindu adults (12.8%, 7.4%, and 12.5%, respectively). Among youth, however, the findings have been different – at least among Hindu youth living outside of India. Bradby and Williams (2006) examined the relationship between religious affiliation and substance use among 824 South Asian adolescents ages 14-15 and 18-20 years living in the greater Glasgow area (Scotland). A goal of the study was to examine the influence of religious affiliation on change in alcohol use, cigarette smoking, and illicit drug use from high school to after high school graduation. Unfortunately, this study compared two separate cohorts rather than prospectively following a single cohort. Participants were 47% Muslim, 10% Sikhs/Hindu, and 43% Christian. Results indicated that Muslims were nearly always less likely than Sikhs/Hindus to have tried alcohol or to be current drinkers. Sikh/Hindu women, however, reported less experimentation with tobacco than did Muslim women. Christians were more likely to report ever having experimented with and currently drinking alcohol, smoking cigarettes, or using illicit drugs than either Muslims or Sikhs/Hindus. However, increases in use from high school to afterward graduation appeared to be largest among Sikh/Hindu males.
Rollocks and Dass (2007) examined the effects of religious affiliation on alcohol use and alcohol attitudes among 380 male and 455 female adolescent ages 13 to 18 years attending high schools in the West Indies. Participants consisted of 44% Christians, 11% Hindus, 6% Muslims, and 39% other religious groups. Uncontrolled results indicated that regular use of alcohol was higher among Hindus than other religious groups (p<0.003), although there was no difference in age at first use or attitudes towards use.
Religious Interventions
At least four clinical trials have examined the effects of Hindu religious interventions on mental health outcomes, all reporting significant benefits.
In a single-group experimental study, Mohan et al (2004) examined the effects of a spiritually-based lifestyle change program (developed by Rishi Samskruit Vidya Kendra) on well-being. Although details are lacking due to inability to access the report, results indicated that the overwhelming majority of 200 participants experienced an increase in their sense of purpose/meaning an din their need to achieve higher consciousness.
Harinath and colleagues (2004) examined the effects of Hatha yoga and Omkar meditation on the mental health of a sample of 30 healthy males aged 25-35 years randomised to either the intervention or a control group. In the morning, participants in the intervention group practised yogic postures for 45 minutes and pranayama (forcefully expiring the breath, breathing air through teeth, alternate nostril breathing, making buzzing sounds with closed lips) for 15 minutes; in the evening, they practised yogic postures for 15 minutes, pranayama for 15 minutes, and meditation (Omkar meditation, i.e., the Om chant) for 30 minutes. These activities were practiced daily for 3 months. Those in the control group performed body flexibility exercises for 40 minutes and running for 20 minutes in the morning and played games for 60 minutes in the evening. Outcomes were anxiety (IPAT Anxiety Scale), depressive symptoms (MMPI), and well-being (50-item scale developed by authors). No significant within group changes in anxiety or depression were found from before to afterwards for either the intervention or the control group, although well-being increased significantly in the intervention group (p<0.001) compared to no change in the control group (post-intervention between group differences were not reported).
Chattha and colleagues (2008) conducted a randomised clinical trial to examine the effects of an integrated yoga intervention on menopausal symptoms among 120 women in Bangalore, India. Menopausal women ages 45-55 years were randomised to either a yoga intervention or a control group. The yoga intervention was based on the original Patanjali yoga sutras and Mandukaya Karika scriptures and consisted of slowing down the flow of thoughts, yogic breathing practices, and simple body movements. These were practiced over 8 weeks. The control group practiced a set of exercises consisting of body movements for one hour daily for five days per week for 8 weeks. Controls received a similar numbers of lectures, and a similar amount of time was spent in individual counselling compared to the intervention group. A total of 54 participants in each group completed the clinical trial. No differences in menopausal symptoms or other characteristics were present at baseline between groups. Outcome measures included the Green Climacteric Scale for psychological, somatic, and vasomotor symptoms, the Perceived Stress Scale, and the Eysenck’s Personality Inventory (assessing extroversion vs. neuroticism). Results indicated a marginally significant between-group difference on psychological symptoms (p=0.06), somatic symptoms (p=0.19), and vasomotor symptoms (p=0.03), all favouring the intervention group. Perceived stress (p<0.001) and neuroticism scores (p<0.05) were also significantly lower in the intervention compared to the control group.
Finally, Satyapriya and colleagues (2009) conducted a randomised clinical trial involving 90 pregnant women in Bangalore, India. Participants in their 18th-20th week of pregnancy were randomised to either an integrated yoga therapy group or a control group (standard prenatal exercises). As in the Chattha et al (2008) study above, those in the yoga intervention group participated yoga based on Hindu scriptures (Patanjali yoga sutras), which consisted of physical postures (asanas) and breathing techniques (pranayama) to improve flexibility, balance, and vita energy (prana). The intervention included meditation (slowing down the flow of thoughts) and relaxation techniques, such as the isomeric relaxation. In the first month, both intervention and control groups received instructions from trainers during 2-hour sessions 3 days per week; for the next three months, women practiced for 1 hour per day at home. In addition, both intervention and control groups had 1-hour refresher classes at each prenatal visit every 4 weeks up to the 28th week and every 2 weeks up to the 36th week. Results at the end of the trial indicated that participants in the intervention group experienced a significant reduction in stress symptoms on the Perceived Stress Scale (between group differences significant at p=0.001), which was the only psychological outcome measured. Not clear was the extent to which participants in the control group received equal social attention as those in the intervention group.
Conclusions
This systematic review of quantitative (and some qualitative) research conducted up through 2010 examined studies that compared Hindus and non-Hindus on mental health (and substance use), explored the relationship between religiosity and mental health in Hindus, and examined the effects of Hindu interventions on mental health outcomes (go to Chapter 8 to see an overall summary of the research findings). One thing is for certain. Hindus often use their religious beliefs to cope with stress; Hindus often explain mental illness in religious terms; and religious treatments are often sought for mental conditions.