Towards a youth mental health paradigm: a perspective and roadmap.

Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.

Yoga: Balancing the excitation-inhibition equilibrium in psychiatric disorders.

Social behavioral disturbances are central to most psychiatric disorders. A disequilibrium within the cortical excitatory and inhibitory neurotransmitter systems underlies these deficits. Gamma-aminobutyric acid (GABA) and glutamate are the most abundant excitatory and inhibitory neurotransmitters in the brain that contribute to this equilibrium. Several contemporary therapies used in treating psychiatric disorders, regulate this GABA-glutamate balance. Yoga has been studied as an adjuvant treatment across a broad range of psychiatric disorders and is shown to have short-term therapeutic gains. Emerging evidence from recent clinical in vivo experiments suggests that yoga improves GABA-mediated cortical-inhibitory tone and enhances peripheral oxytocin levels. This is likely to have a more controlled downstream response of the hypothalamo-pituitary-adrenal system by means of reduced cortisol release and hence a blunted sympathetic response to stress. Animal and early fetal developmental studies suggest an inter-dependent role of oxytocin and GABA in regulating social behaviors. In keeping with these observations, we propose an integrated neurobiological model to study the mechanisms of therapeutic benefits with yoga. Apart from providing a neuroscientific basis for applying a traditional system of practice in the clinical setting, this model can be used as a framework for studying yoga mechanisms in future clinical trials.

Bridging the schism of schizophrenia through yoga-Review of putative mechanisms.

Schizophrenia patients experience a 'disconnect' at multiple levels-neuronal networks, mental processes, and interpersonal relationships. The resultant poor quality-of-life and functional disability are related to the persistent cognitive deficits and negative symptoms, which are rather resistant to conventional antipsychotic medications. Yoga has emerged as an important therapeutic intervention to improve quality-of-life in schizophrenia. Recent preliminary evidence suggests that effects of yoga on cognitive and negative symptoms may drive this benefit. This study attempts to integrate evidence from neuroscience-based research, which focuses on the neuroplasticity-harnessing effects of yoga to bridge the schizophrenia connectopathy. In an overarching model to study putative neurobiological mechanisms that drive therapeutic effects of yoga, it is proposed that (a) various styles of meditation may help in strengthening the lateral and medial prefrontal brain networks, thus improving neurocognition and mentalizing abilities, and (b) learning and performing co-ordinated physical postures with a teacher facilitates imitation and the process of being imitated, which can improve social cognition and empathy through reinforcement of the premotor and parietal mirror neuron system. Oxytocin may play a role in mediating these processes, leading to better social connectedness and social outcomes. Clinical and heuristic implications of this model are further discussed.