Effects of Qigong on Depression: A Systemic Review

Table 1

Two studies investigating the effects of Qigong on depression as primary and eight studies as secondary outcomes.

Author; Year; Country	Design Blinding	Sample size	Subject; Mean age; Sex (m/f)	Intervention; control	Outcome measure; Followup; Analysis	Result; Dropout	Adverse event	Conclusion and discussion
Tsang et al. [23]; 2003; Hong; Kong	RCT; Non-blinding	Total (𝑛=50); Intervention; (𝑛=25); Control (𝑛=25)	Geriatric patients; 74; (26/24)	Eight-section brocades Qigong; (a) 12 weeks; (b) 60 minutes; (c) 6 visits; (d) 2x/week; Traditional remedial rehabilitation activities	(1) Geriatric Depression Scale; (2) Perceived Benefit Questionnaire; (3) Hong Kong Chinese Version World Health Organization Quality of Life; (4) Self-concept Scale; No follow-up	(1) NS; (2) 𝑃<0.001; (3) NS; (4) NS; n/a	Not reported	Eight section brocades Qigong is promising as an alternative psychosocial intervention for depressed elderly with chronic physical illness. Although there is no evidence, there is an optimistic stance that Qigong results in better treatment compliance and better outcome compared to Western exercise protocols like aerobics
Astin et al. [29]; 2003; USA	RCT; Non-blinding	Total (𝑛=128); Intervention; (𝑛=64); Control (𝑛=64)	Patients with fibromyalgia syndrome; 48; (1/127)	Mindfulness meditation with Qigong movement therapy; (a) 8 weeks; (b) 150 minutes (90 min mindfulness, 60 min Qigong); (c) 8 visits; (d) 1x/week; Education support group	(1) Pain measured with 36-Item Short-Form Health Survey; (2) Fibromyalgia Impact Questionnaire; (3) Beck Depression Inventory; (4) Myalgic score; (5) Coping strategies; Follow-up; (a) Week 4; (b) Week 24; Completers analysis	(1) NS; (2) NS; (3) NS; (4) NS; (5) NS; 49%	Not reported	Both intervention and control groups showed improvement on a number of outcome variables, however, no evidence showed that the mindfulness meditation and Qigong intervention for fibromyalgia was superior to education support group.
Kim et al. [24]; 2004; Korea	RCT; Non-blinding	Total (𝑛=54); Intervention (𝑛=26); Control (𝑛=28)	Female college students; 19–21; (0/54)	Meridian exercise; (a) 6 weeks; (b) 30 minutes; (c) 12 visits; (d) 2x/week; Standard care only	(1) State Anxiety Inventory; (2) Depression Status Inventory; (3) Self-Esteem Inventory; No followup: ITT analyses	(1) 𝑃<0.001; (2) 𝑃<0.001; (3) 𝑃<0.001; n/a	Not reported	Meridian exercise decreased anxiety and depression and increased self-esteem. Study suggests that meridian exercise enabled female students to manage their mental health within the community. Future studies are needed to examine the lasting effect of the intervention, including physiological indices
Cheung et al. [27]; 2005; Hong Kong	RCT; Non-blinding	Total (𝑛=91); Intervention (𝑛=47); Control (𝑛=44)	Patients with essential hypertension; 54; (37/51)	Guolin Qigong; (a) 4 weeks; (b) 120 minutes; (c) 8 visits; (d) 2x/week; Conventional exercise	(1) Blood pressure; (2) 36-Item Short-Form Health Survey; (3) Beck Anxiety Inventory; (4) Beck Depression Inventory; No followup; ITT analyses	(1) NS; (2) NS; (3) NS; (4) NS; 16.5%	Vestibular neuronitis, unrelated to Qigong practice	Goulin Qigong and conventional exercise had similar effects on blood pressure in patients with mild hypertension. While no additional benefits were identified, Qigong treatment serves as a nondrug alternative to conventional exercise in the treatment of hypertension
Tsang et al. [13]; 2006; Hong; Kong	RCT; Single blind	Total (𝑛=82); Intervention; (𝑛=34); Control (𝑛=48)	Geriatric patients; 82; (16/66)	Baduanjin Qigong; (a) 16 weeks; (b) 30–45 minutes; (c) 48 visits; (d) 3x/week; Newspaper reading	(1) Geriatric Depression; Scale; (2) Chinese General Self-Efficacy Scale; (3) Personal Well-Being Index; (4) General Health Questionnaire-12; (5) Self-Concept Scale; (6) Perceived Benefit Questionnaire; Followup: (a) Week 4; (b) Week 8	(1) 𝑃=0.041; (2) 𝑃<0.001; (3) 𝑃<0.001; (4) 𝑃=0.042; (5) Subscales significant; (6) 𝑃<0.001; 15.8%	Not reported	Regular Qigong practice could reduce depression, and improve self-efficacy and personal well-being among geriatric patients with chronic physical illness and depression. Study shows that practice needs to continue and last for long-term effects
Schmitz-Hübsch et al. [30]; 2006; Germany	RCT; Non-blinding; Pilot study	Total (𝑛=56); Intervention (𝑛=32); Control (𝑛=24)	Patients with Parkinson's Disease; 63; (43/13)	Qigong (frolic of the crane, eight-section brocades in sitting position); (a) 24 weeks (8-week intervention, 8-week no intervention, 8-week intervention); (b) 90 minutes; (c) 16 visits; (d) 1x/week; No intervention	(1) Unified Parkinson's Disease Rating Scale-Motor; (2) Parkinson’s Disease Questionnaire; (3) Montgomery-Asperg Depression Rating Scale; Followup: (a) 12 months; ITT analyses	(1) 𝑃=0.008; (2) NS; (3) NS; 12.5%	Not reported	Results suggest positive effects of Qigong on symptoms of autonomic dysfunction in patients with Parkinson’s disease. Given high acceptance and compliance with therapy, Qigong is a promising treatment with possible effects on motor as well as nonmotor symptoms. Group instruction, as well as self-exercise of Qigong, moreover serves as cost-effective application
Johansson et al. [25]; 2008; Sweden	RCT; Non-blinding	Total (𝑛=59); Intervention (𝑛=28); Control (𝑛=31)	Summer school camp participants; 51; (8/51)	Jichu Gong; (a) 4-day retreat; Lecture on Chinese medicine	(1) Profile of Mood Status; (2) State and Trait Anxiety Inventory; No followup; Completers analyses	(1) 𝑃<0.0005; (2) 𝑃<0.0005; 3%	Not reported	Study supports the effectiveness of Qigong to promote mental health. More studies are necessary to verify the finding
Oh et al. [26]; 2009; Australia	RCT; Non-blinding	Total (𝑛=162); Intervention (𝑛=79); Control (𝑛=83)	Cancer patients; 60; (69/93)	Medical Qigong + standard care; (a) 12 weeks; (b) 90 minutes; (c) 12 visits; (d) 1x/week; Standard care only	(1) Functional Assessment of Cancer Therapy-General; (2) Functional Assessment of Cancer Therapy-Fatigue; (3) Profile of Mood Status; (4) Inflammation (CRP); No followup; ITT analyses	(1) 𝑃<0.01; (2) 𝑃<0.01; (3) 𝑃=0.021  (mood disturbance); 𝑃=0.0290 (depression); (4) 𝑃=0.044; 24%	Reported no adverse event	Medical Qigong can improve cancer patients overall quality of life and mood status as well as reduce specific side effects of cancer treatment. Qigong treatment may also produce long-term physical benefits due to reduction of CRP inflammation
Stenlund et. al. [31]; 2009; Sweden	RCT; Non-blinding	Total (𝑛=82); Intervention; (𝑛=41); Control (𝑛=41)	Patients with burnout	Qigong + basic care; (a) 12 weeks; (b) 60 minutes; (c) 12 visits; (d) 1x/week; Basic care at the stress clinic	(1) Shirom-Melamed Burnout Questionnaire; (2) 36-Item Short Form Health Survey (Swedish); (3) Self-Concept Questionnaire; (4) Checklist Individual Strength Questionnaire; (5) Hospital Anxiety and Depression Scale; (6) Physical Assessment Scale of the Relaxation Inventory; No followup; ITT analyses; Completers analyses	(1) NS; (2) NS; (3) NS; (4) NS; (5) NS; (6) NS; 17%	Not reported	12-week intervention of Qigong had no additional benefit compared to basic care in burnout patients