{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:10:37Z","timestamp":1791803437490,"version":"4.3.4"},"reference-count":53,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Veterans Affairs Rehabilitation Research and Development Service","award":["I01 RX001485-01"],"award-info":[{"award-number":["I01 RX001485-01"]}]},{"name":"Veterans Health Administration, Office of Academic Affiliations","award":["No grant number."],"award-info":[{"award-number":["No grant number."]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,23]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Test whether Sudarshan Kriya Yoga (SKY) was non-inferior to cognitive processing therapy (CPT) for treating symptoms of post-traumatic stress disorder (PTSD) among veterans via a parallel randomised controlled non-inferiority trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outpatient Veterans Affairs healthcare centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>85 veterans (75 men, 61% white, mean age 56.9) with symptoms of PTSD participated between October 2015 and March 2020: 59 participants completed the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>SKY emphasises breathing routines and was delivered in group format in a 15-hour workshop followed by two 1-hour sessions per week for 5 weeks. CPT is an individual psychotherapy which emphasises shifting cognitive appraisals and was delivered in two 1-hour sessions per week for 6 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>The primary outcome measure was the PTSD Checklist-Civilian Version (PCL-C). The secondary measures were the Beck Depression Inventory-II (BDI-II) and Positive and Negative Affect Scale (PANAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean PCL-C at baseline was 56.5 (\u00b112.6). Intent-to-treat analyses showed that PCL-C scores were reduced at 6\u2009weeks (end of treatment) relative to baseline (SKY, \u22125.6,\n                      <jats:italic>d=<\/jats:italic>\n                      0.41, n=41: CPT, \u22126.8,\n                      <jats:italic>d=<\/jats:italic>\n                      0.58, n=44). The between-treatment difference in change scores was within the non-inferiority margin of 10 points (\u22121.2, 95%\u2009CI \u22125.7 to 3.3), suggesting SKY was not inferior to CPT. SKY was also non-inferior at 1-month (CPT\u2013SKY: \u22122.1, 95%\u2009CI \u22126.9 to 2.8) and 1-year (CPT\u2013SKY: \u22121.8, 95%\u2009CI \u22126.6 to 2.9) assessments. SKY was also non-inferior to CPT on the BDI-II and PANAS at end of treatment and 1\u2009month, but SKY was inferior to CPT on both BDI-II and PANAS at 1\u2009year. Dropout rates were similar (SKY, 27%, CPT, 34%: OR=1.36, 95%\u2009CI 0.51 to 3.62, p=0.54).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SKY may be non-inferior to CPT for treating symptoms of PTSD and merits further consideration as a treatment for PTSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02366403\">NCT02366403<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  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