Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis

Dauwan, Meenakshi; Begemann, Marieke J. H.; Heringa, Sophie M.; Sommer, Iris E.

doi:10.1093/schbul/sbv164

Cited by 393Schizophrenia research and treatmentPhysical Activity and HealthMental Health and Psychiatry

Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis

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Dauwan, Meenakshi, Begemann, Marieke J. H., Heringa, Sophie M., Sommer, Iris E.·2016·Schizophrenia Bulletin

DOI 10.1093/schbul/sbv164PMC PMC4838091

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Abstract

BACKGROUND: Physical exercise may be valuable for patients with schizophrenia spectrum disorders as it may have beneficial effect on clinical symptoms, quality of life and cognition. METHODS: A systematic search was performed using PubMed (Medline), Embase, PsychInfo, and Cochrane Database of Systematic Reviews. Controlled and uncontrolled studies investigating the effect of any type of physical exercise interventions in schizophrenia spectrum disorders were included. Outcome measures were clinical symptoms, quality of life, global functioning, depression or cognition. Meta-analyses were performed using Comprehensive Meta-Analysis software. A random effects model was used to compute overall weighted effect sizes in Hedges' g. RESULTS: Twenty-nine studies were included, examining 1109 patients. Exercise was superior to control conditions in improving total symptom severity (k = 14, n = 719: Hedges' g = .39, P < .001), positive (k = 15, n = 715: Hedges' g = .32, P < .01), negative (k = 18, n = 854: Hedges' g = .49, P < .001), and general (k = 10, n = 475: Hedges' g = .27, P < .05) symptoms, quality of life (k = 11, n = 770: Hedges' g = .55, P < .001), global functioning (k = 5, n = 342: Hedges' g = .32, P < .01), and depressive symptoms (k = 7, n = 337: Hedges' g = .71, P < .001). Yoga, specifically, improved the cognitive subdomain long-term memory (k = 2, n = 184: Hedges' g = .32, P < .05), while exercise in general or in any other form had no effect on cognition. CONCLUSION: Physical exercise is a robust add-on treatment for improving clinical symptoms, quality of life, global functioning, and depressive symptoms in patients with schizophrenia. The effect on cognition is not demonstrated, but may be present for yoga.

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In schizophrenia spectrum disorders, aerobic exercise does not improve depressive symptoms.
“Data from one MA [69] of 5 RCTs found that aerobic exercise does not improve depressive symptoms”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [69]
The Discussion (page unavailable) says the evidence for reducing depressive symptoms points more toward yoga than aerobic exercise, but it does not state that aerobic exercise has no effect on depression. The Secondary Outcome Measures report a significant reduction in depression for exercise overall, and Table 1 lists seven studies for that outcome, not five RCTs. (LLM, conf=0.78)
Experimental — accuracy not yet measured
In people with anxiety and stress disorders, exercise was effective versus non-active interventions in reducing anxiety symptoms.
“In those with anxiety and stress disorders, there was evidence that exercise was effective versus non-active interventions in reducing anxiety symptoms [33,34,69].”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [69]
The Type of Exercise section says physical exercise reduces state anxiety and psychological distress in people with schizophrenia. The paper does not establish the claimed effect in people with anxiety or stress disorders, or specify a comparison with non-active interventions for the anxiety outcome. The passive-control comparisons in Primary Outcome Measure: Clinical Symptoms concern schizophrenia symptom severity, not anxiety symptoms. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Aerobic exercise does improve depressive symptoms in schizophrenia.
“It does appear from the paucity of RCTs available that aerobic exercise does improve depressive symptoms in schizophrenia [69].”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [69]
The Secondary Outcome Measures section reports that exercise overall reduced depression in patients with schizophrenia spectrum disorders. The Discussion says the evidence for reducing depressive symptoms points more toward yoga; it does not establish the claimed improvement specifically for aerobic exercise. No page number is available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
In schizophrenia spectrum disorders, exercise as an adjunctive treatment reduces negative symptoms compared with control.
“as an adjunctive treatment for reducing positive and negative symptoms of schizophrenia (metaanalyses = 2)”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [69]
In schizophrenia spectrum disorders, exercise as an adjunctive treatment reduces positive symptoms compared with control.
“as an adjunctive treatment for reducing positive and negative symptoms of schizophrenia (metaanalyses = 2)”
From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [69]

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Márquez, D. X., Aguiñaga, S., Vásquez, P. M., Conroy, D. E., Erickson, K. I., Hillman, C. H., Stillman, C. M., Ballard, R., Sheppard, B. B., Petruzzello, S. J., et al. (2020) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz198 · Cited by 618 · see citing works
Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis
Firth, J., Stubbs, B., Rosenbaum, S., Vancampfort, D., Malchow, B., Schuch, F., Elliott, R., Nuechterlein, K. H., & Yung, A. R. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw115 · Cited by 488 · see citing works
Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes
Ashdown-Franks, G., Firth, J., Carney, R., Carvalho, A. F., Hallgren, M., Koyanagi, A., Rosenbaum, S., Schuch, F. B., Smith, L., Solmi, M., et al. (2020) · Sports Medicine · doi:10.1007/s40279-019-01187-6 · Cited by 446 · see citing works
Depression and the Link with Cardiovascular Disease
Dhar, A. K., & Barton, D. A. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00033 · Cited by 404 · see citing works
The Effect of Exercise Training on Resting Concentrations of Peripheral Brain-Derived Neurotrophic Factor (BDNF): A Meta-Analysis
Dinoff, A., Herrmann, N., Swardfager, W., Liu, C. S., Sherman, C., Chan, S. W., & Lanctôt, K. L. (2016) · PLoS ONE · doi:10.1371/journal.pone.0163037 · Cited by 343 · see citing works
The effect of acute exercise on blood concentrations of brain-derived neurotrophic factor in healthy adults. A meta-analysis.
Dinoff, A., Herrmann, N., Swardfager, W., & Lanctôt, K. L. (2017) · European Journal of Neuroscience · doi:10.1111/ejn.13603 · Cited by 323 · see citing works
“…alleviate psychiatric symptoms in some individuals (Wipfli et al., 2008; Rethorst et al., 2009; Basso et al., 2015; Best et al., 2015; Bossers et al., 2015; Dauwan et al., 2015; Hagovska et al., 2015; Kerling et al., 2015; Knapen et al., 2015; Pedersen & Saltin, 2015; de Souza Moura et al., 2015).”
Background
Blood-brain barrier permeability and physical exercise
Małkiewicz, M. A., Szarmach, A., Sabisz, A., Cubała, W. J., Szurowska, E., & Winklewski, P. J. (2019) · Journal of Neuroinflammation · doi:10.1186/s12974-019-1403-x · Cited by 276 · see citing works
Physical exercise improves quality of life, depressive symptoms, and cognition across chronic brain disorders: a transdiagnostic systematic review and meta-analysis of randomized controlled trials
Dauwan, M., Begemann, M. J. H., Slot, M. I. E., Lee, E. H. M., Scheltens, P., & Sommer, I. E. C. (2021) · Journal of Neurology · doi:10.1007/s00415-019-09493-9 · Cited by 239 · see citing works
“Second, our findings are largely in accordance with previous (quantitative) reviews that synthesized evidence on the efficacy of physical exercise in the studied brain disorders [20, 22, 24, 25, 28, 252].”
BackgroundMethodResultSelf-citation
EPA guidance on treatment of negative symptoms in schizophrenia
Galderisi, S., Kaiser, S., Bitter, I., Nordentoft, M., Mucci, A., Sabé, M., Giordano, G. M., Nielsen, M. Ø., Glenthøj, L. B., Pezzella, P., et al. (2021) · European Psychiatry · doi:10.1192/j.eurpsy.2021.13 · Cited by 182 · see citing works
“In a meta-analysis, Dauwan and colleagues showed broad beneficial effects of a heterogeneous set of exercise interventions on negative symptoms, but also on other symptom dimensions, quality of life, and global functioning [79].”
Background
The Effects and Mechanisms of Exercise on the Treatment of Depression
Xie, Y., Wu, Z., Sun, L., Zhou, L., Wang, G., Xiao, L., & Wang, H. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.705559 · Cited by 194 · see citing works
The beneficial effects of physical exercise in the brain and related pathophysiological mechanisms in neurodegenerative diseases
Liu, Y., Yan, T., Chu, J. M. T., Chen, Y., Dunnett, S. L., Ho, J. Y. S., Wong, G. T. C., & Chang, R. C. (2019) · Laboratory Investigation · doi:10.1038/s41374-019-0232-y · Cited by 161 · see citing works
“Interestingly, physical exercise has not only been demonstrated to reduce overall symptoms in schizophrenia, but also was found to be more effective in dealing with negative symptoms than positive symptoms [21].”
Background
Aerobic Exercise as a Tool to Improve Hippocampal Plasticity and Function in Humans: Practical Implications for Mental Health Treatment
Kandola, A., Hendrikse, J., Lucassen, P. J., & Yücel, M. (2016) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2016.00373 · Cited by 155 · see citing works
“Although one review was unable to ﬁnd an association between AE and a reduction of cognitive symptoms in patients with schizophrenia (Dauwan et al., 2016) these early results are largely promising.”
Sports psychiatry: mental health and mental disorders in athletes and exercise treatment of mental disorders
Ströhle, A. (2018) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-018-0891-5 · Cited by 160 · see citing works
Exercise mimetics: harnessing the therapeutic effects of physical activity
Gubert, C., & Hannan, A. J. (2021) · Nature Reviews Drug Discovery · doi:10.1038/s41573-021-00217-1 · Cited by 153 · see citing works
European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia
Vita, A., Gäebel, W., Mucci, A., Sachs, G., Barlati, S., Giordano, G. M., Nibbio, G., Nordentoft, M., Wykes, T., & Galderisi, S. (2022) · European Psychiatry · doi:10.1192/j.eurpsy.2022.2315 · Cited by 134 · see citing works
“All these findings are in contrast with the results of a previous meta-analysis [122] that reported improvements in clinical symptoms, quality of life, global functioning, and depressive symptoms, but failed to observe a significant effect of physical exercise on cognitive performance.”
Result
Feasibility of PRIME: A Cognitive Neuroscience-Informed Mobile App Intervention to Enhance Motivated Behavior and Improve Quality of Life in Recent Onset Schizophrenia
Schlosser, D., Campellone, T., Kim, D., Truong, B., Vergani, S., Ward, C., & Vinogradov, S. (2016) · JMIR Research Protocols · doi:10.2196/resprot.5450 · Cited by 103 · see citing works
“With PRIME, participants join a supportive online environment where they can select and document progress on small, self-determined goals in four key domains that have been shown to be significantly associated with better quality of life: (1) health/wellness [28,29], (2) social relationships [30], (3) creativity [31],…”
Effects of physical exercise on executive function in cognitively healthy older adults: A systematic review and meta-analysis of randomized controlled trials
Xiong, J., Ye, M., Wang, L., & Zheng, G. (2020) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2020.103810 · Cited by 123 · see citing works
Diet and Psychosis: A Scoping Review
Aucoin, M., LaChance, L., Cooley, K., & Kidd, S. A. (2018) · Neuropsychobiology · doi:10.1159/000493399 · Cited by 114 · see citing works
A Scientometrics Analysis and Visualization of Depressive Disorder
Xu, D. W., Wang, Y., Wang, K.-T., Wang, Y., Dong, X., Tang, J., & Cui, Y. (2020) · Current Neuropharmacology · doi:10.2174/1570159x18666200905151333 · Cited by 107 · see citing works
Physical exercise for negative symptoms of schizophrenia: Systematic review of randomized controlled trials and meta-analysis
Sabé, M., Kaiser, S., & Sentissi, O. (2019) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2019.11.002 · Cited by 100 · see citing works
Exercise Intensity and Recovery on Circulating Brain-derived Neurotrophic Factor
REYCRAFT, J. T., Islam, H., Townsend, L. K., Hayward, G. C., Hazell, T. J., & MacPherson, R. E. K. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002242 · Cited by 100 · see citing works
Exercise as a Treatment for Schizophrenia: A Review
Girdler, S. J., Confino, J., & Woesner, M. E. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4584 · Cited by 100 · see citing works
Health benefits, safety and cost of physical activity interventions for mental health conditions: A meta-review to inform translation efforts
Czosnek, L., Lederman, O., Cormie, P., Zopf, E., Stubbs, B., & Rosenbaum, S. (2019) · Mental Health and Physical Activity · doi:10.1016/j.mhpa.2018.11.001 · Cited by 94 · see citing works
In- and outpatient lifestyle interventions on diet and exercise and their effect on physical and psychological health: a systematic review and meta-analysis of randomised controlled trials in patients with schizophrenia spectrum disorders and first episode of psychosis
Fernández-Abascal, B., Suárez‐Pinilla, P., Cobo-Corrales, C., Crespo‐Facorro, B., & Suárez‐Pinilla, M. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.005 · Cited by 93 · see citing works
“The present meta-analysis did found beneficial effect of exercise (but not psychotherapy) on global functioning and QoL outcomes, in accordance with a metaanalysis pointing exercise as a robust add-on treatment for improving QoL and overall functioning (Dauwan et al., 2016), and with another study comparing effects of…”
Result
Cognitive benefits of exercise interventions: an fMRI activation likelihood estimation meta-analysis
Yu, Q., Herold, F., Becker, B., Klugah‐Brown, B., Zhang, Y., Perrey, S., Veronese, N., Müller, N. G., Kramer, A. F., & Zou, L. (2021) · Brain Structure and Function · doi:10.1007/s00429-021-02247-2 · Cited by 98 · see citing works
Effects of Aerobic Exercise on Metabolic Syndrome, Cardiorespiratory Fitness, and Symptoms in Schizophrenia Include Decreased Mortality
Schmitt, A., Maurus, I., Rossner, M. J., Röh, A., Lembeck, M., von Wilmsdorff, M., Takahashi, S., Rauchmann, B., Keeser, D., Hasan, A., et al. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00690 · Cited by 93 · see citing works
“Importantly, in 45% of the multi-episode schizophrenia patients who performed aerobic exercise the Global Assessment of Functioning (GAF) score improved by about 20% from baseline to month 3 (90); thus, this study showed that aerobic exercise as add-on therapy fosters patients’ capacity to improve in multi-epsode schi…”
Background
Treatment for Negative Symptoms in Schizophrenia: A Comprehensive Review
Veerman, S. R. T., Schulte, P. F. J., & de Haan, L. (2017) · Drugs · doi:10.1007/s40265-017-0789-y · Cited by 96 · see citing works
Wearable devices and mobile technologies for supporting behavioral weight loss among people with serious mental illness
Naslund, J. A., Aschbrenner, K. A., Scherer, E. A., McHugo, G. J., Marsch, L. A., & Bartels, S. J. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.06.056 · Cited by 86 · see citing works
“Recent meta-analyses have also demonstrated that physical activity contributes to reduction in mental health symptom severity among people with serious mental illness (Dauwan et al., 2015; Firth et al., 2015a).”
Background
Barriers and facilitators to health care providers’ promotion of physical activity for individuals with mental illness: A scoping review
Glowacki, K., Weatherson, K. A., & Faulkner, G. (2018) · Mental health and physical activity · doi:10.1016/j.mhpa.2018.10.006 · Cited by 82 · see citing works
Aerobic exercise and cognitive functioning in schizophrenia: An updated systematic review and meta-analysis
Shimada, T., Ito, S., Makabe, A., Yamanushi, A., Takenaka, A., Kawano, K., & Kobayashi, M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114656 · Cited by 81 · see citing works
From impact factors to real impact: translating evidence on lifestyle interventions into routine mental health care
Deenik, J., Czosnek, L., Teasdale, S. B., Stubbs, B., Firth, J., Schuch, F. B., Tenback, D. E., van Harten, P. N., Tak, E. C. P. M., Lederman, O., et al. (2020) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz067 · Cited by 77 · see citing works
Evidence-based psychosocial interventions in schizophrenia: a critical review
Barlati, S., Nibbio, G., & Vita, A. (2024) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000925 · Cited by 95 · see citing works
“that, when delivered to people living with SSD, have been show to improve the likelihood of obtaining a competitive job and to improve the number of hours worked in any job [67].”
Background
A meta‐analysis of deep brain structural shape and asymmetry abnormalities in 2,833 individuals with schizophrenia compared with 3,929 healthy volunteers via the ENIGMA Consortium
Gutman, B. A., van Erp, T. G. M., Alpert, K. I., Ching, C. R. K., Isaev, D., Ragothaman, A., Jahanshad, N., Saremi, A., Zavaliangos‐Petropulu, A., Glahn, D. C., et al. (2021) · Human Brain Mapping · doi:10.1002/hbm.25625 · Cited by 76 · see citing works
Exercise Treatments for Psychosis: a Review
Mittal, V. A., Vargas, T., Osborne, K. J., Dean, D. J., Gupta, T., Ristanovic, I., Hooker, C. I., & Shankman, S. A. (2017) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-017-0112-2 · Cited by 76 · see citing works
The Implementation of Evidence-Based Psychiatric Rehabilitation: Challenges and Opportunities for Mental Health Services
Vita, A., & Barlati, S. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00147 · Cited by 74 · see citing works
The effect of mind-body and aerobic exercise on negative symptoms in schizophrenia: A meta-analysis
Vogel, J. S., van der Gaag, M., Slofstra, C., Knegtering, H., Bruins, J., & Castelein, S. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.03.012 · Cited by 73 · see citing works
“Furthermore, we excluded one of two articles (Behere et al., 2011; Varambally et al., 2012) from the same study to avoid bias in the e ﬀ ect size, whereas Dauwan et al. (2015) included both articles.”
Influential
Outdoor cycling improves clinical symptoms, cognition and objectively measured physical activity in patients with schizophrenia: A randomized controlled trial
Ryu, J.-K., Jung, J. H., Kim, J., Kim, C., Lee, H.-B., Kim, D., Lee, S., Shin, J., & Roh, D. D. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.10.015 · Cited by 70 · see citing works
Meditation-based mind-body therapies for negative symptoms of schizophrenia: Systematic review of randomized controlled trials and meta-analysis
Sabe, M., Sentissi, O., & Kaiser, S. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.07.030 · Cited by 72 · see citing works
Physical activity and quality of life in long-term hospitalized patients with severe mental illness: a cross-sectional study
Deenik, J., Kruisdijk, F. R., Tenback, D. E., Braakman‐Jansen, A., Taal, E., Hopman-Rock, M., Beekman, A. T. F., Tak, E. C. P. M., Hendriksen, I. J. M., & van Harten, P. N. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1466-0 · Cited by 67 · see citing works
Neurobiological effects of aerobic exercise, with a focus on patients with schizophrenia
Maurus, I., Hasan, A., Röh, A., Takahashi, S., Rauchmann, B., Keeser, D., Malchow, B., Schmitt, A., & Falkai, P. (2019) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-01025-w · Cited by 62 · see citing works
Polygenic risk has an impact on the structural plasticity of hippocampal subfields during aerobic exercise combined with cognitive remediation in multi-episode schizophrenia
Papiol, S., Popovic, D., Keeser, D., Hasan, A., Schneider-Axmann, T., Degenhardt, F., Rossner, M. J., Bickeböller, H., Schmitt, A., Falkai, P., et al. (2017) · Translational Psychiatry · doi:10.1038/tp.2017.131 · Cited by 62 · see citing works
Bipolar and psychotic disorders in elite athletes: a narrative review
Currie, A., Gorczynski, P., Rice, S. M., Purcell, R., McAllister-Williams, R. H., Hitchcock, M. E., Hainline, B., & Reardon, C. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100685 · Cited by 41 · see citing works
Changes in physical and psychiatric health after a multidisciplinary lifestyle enhancing treatment for inpatients with severe mental illness: The MULTI study I
Deenik, J., Tenback, D. E., Tak, E. C. P. M., Rutters, F., Hendriksen, I. J. M., & van Harten, P. N. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.07.033 · Cited by 60 · see citing works
“, 2015) as well with beneficial changes in psychotic symptoms (Dauwan et al., 2016; Rosenbaum et al., 2014).”
Exercise mimetics: a novel strategy to combat neuroinflammation and Alzheimer’s disease
Zhao, R. (2024) · Journal of Neuroinflammation · doi:10.1186/s12974-024-03031-9 · Cited by 62 · see citing works
Yoga versus standard care for schizophrenia
Broderick, J. M., Knowles, A., Chadwick, J., & Vancampfort, D. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010554.pub2 · Cited by 55 · see citing works
Updated perspectives on the clinical significance of negative symptoms in patients with schizophrenia
Giordano, G. M., Caporusso, E., Pezzella, P., & Galderisi, S. (2022) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2022.2092402 · Cited by 56 · see citing works
Protective factors for psychotic experiences amongst adolescents exposed to multiple forms of victimization
Crush, E., Arseneault, L., Moffitt, T. E., Danese, A., Caspi, A., Jaffee, S. R., Matthews, T., & Fisher, H. L. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.06.011 · Cited by 53 · see citing works
“, 2017) and the benefit of exercise interventions for reducing psychotic phenomena amongst those at risk for psychosis as well as clinical groups suffering from psychotic disorders and also depression (Dauwan et al., 2016; Firth et al., 2015; Firth et al., 2016).”
Background
Effects of high intensity interval training among overweight individuals with psychotic disorders: A randomized controlled trial
Romain, A. J., Fankam, C., Karelis, A. D., Letendre, E., Mikolajczak, G., Stip, É., & Abdel‐Baki, A. (2018) · Schizophrenia Research · doi:10.1016/j.schres.2018.12.021 · Cited by 52 · see citing works
The effect of exercise on global, social, daily living and occupational functioning in people living with schizophrenia: A systematic review and meta-analysis
Korman, N., Stanton, R., Vecchio, A., Chapman, J. J., Parker, S., Martland, R., Siskind, D. J., & Firth, J. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.04.012 · Cited by 51 · see citing works
The impact of exercise on mental health during the COVID-19 pandemic: a systematic review and meta-analysis
Wang, C., Tian, Z., & Luo, Q. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1279599 · Cited by 49 · see citing works
Aerobic exercise and cognitive functioning in schizophrenia: A pilot randomized controlled trial
Shimada, T., Ito, S., Makabe, A., Yamanushi, A., Takenaka, A., & Kobayashi, M. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112638 · Cited by 50 · see citing works
Effects of childhood and adolescence physical activity patterns on psychosis risk—a general population cohort study
Sormunen, E., Saarinen, M. M., Salokangas, R. K. R., Telama, R., Hutri‐Kähönen, N., Tammelin, T., Viikari, J. S. A., Raitakari, O. T., & Hietala, J. A. (2017) · Schizophrenia · doi:10.1038/s41537-016-0007-z · Cited by 48 · see citing works
Aerobic exercise and its effects on cognition in schizophrenia
Falkai, P., Malchow, B., & Schmitt, A. (2017) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000326 · Cited by 48 · see citing works
Telepsychotherapy with youth at clinical high risk for psychosis: Clinical issues and best practices during the COVID-19 pandemic.
DeLuca, J. S., Andorko, N. D., Chibani, D., Jay, S. Y., Rouhakhtar, P. R., Petti, E., Klaunig, M. J., Thompson, E. C., Millman, Z. B., Connors, K. M., et al. (2020) · Journal of Psychotherapy Integration · doi:10.1037/int0000211 · Cited by 46 · see citing works
Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT
Schmid, A. A., Fruhauf, C. A., Sharp, J. L., Puymbroeck, M. V., Bair, M. J., & Portz, J. D. (2019) · Journal of Evidence-Based Integrative Medicine · doi:10.1177/2515690x19863763 · Cited by 47 · see citing works
Mindful exercise versus non-mindful exercise for schizophrenia: A systematic review and meta-analysis of randomized controlled trials
Li, J., Shen, J., Wu, G., Tan, Y., Sun, Y., Keller, E., Jiang, Y., & Wu, J. (2018) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2018.04.003 · Cited by 44 · see citing works
Managing Negative Symptoms of Schizophrenia: How Far Have We Come?
Kantrowitz, J. T. (2017) · CNS Drugs · doi:10.1007/s40263-017-0428-x · Cited by 43 · see citing works
The Effects of Exercise on IL-6 Levels and Cognitive Performance in Patients with Schizophrenia
Gómez-Rubio, P., & Trapero, I. (2019) · Diseases · doi:10.3390/diseases7010011 · Cited by 43 · see citing works
“The neuroprotective effect induced by exercise has also been observed in people with dementia and cognitive disability [18], reducing their symptoms and improving cognitive functions in both young people and adults [19].”
Background
Improved psychosocial functioning and quality of life in inpatients with severe mental illness receiving a multidisciplinary lifestyle enhancing treatment. The MULTI study II
Deenik, J., Tenback, D. E., Tak, E. C. P. M., Hendriksen, I. J. M., & van Harten, P. N. (2018) · Mental health and physical activity · doi:10.1016/j.mhpa.2018.10.004 · Cited by 39 · see citing works
Treating depressive episodes or symptoms in patients with schizophrenia
van Rooijen, G., Vermeulen, J. M., Ruhé, H. G., & de Haan, L. (2017) · CNS Spectrums · doi:10.1017/s1092852917000554 · Cited by 39 · see citing works
“A recent systematic review and meta-analysis by Dauwan et al.(11) examined the effect of exercise in patients with schizophrenia on several outcome measures, including depressive symptoms.”
Background
Improving the health of mental health staff through exercise interventions: a systematic review
Fibbins, H., Ward, P. B., Watkins, A., Curtis, J., & Rosenbaum, S. (2018) · Journal of Mental Health · doi:10.1080/09638237.2018.1437614 · Cited by 39 · see citing works
“Additionally, physical activity and its structured subset, exercise, results in improved mental health symptoms (Dauwan et al., 2016; Firth et al., 2015) as well as cognitive (Firth et al., 2016) and psychosocial functioning (Firth et al., 2015; Vancampfort et al., 2015).”
Background
Neural correlates of exercise training in individuals with schizophrenia and in healthy individuals: A systematic review
van der Stouwe, E. C. D., van Busschbach, J. T., de Vries, B., Cahn, W., Aleman, A., & Pijnenborg, G. H. M. (2018) · NeuroImage Clinical · doi:10.1016/j.nicl.2018.04.018 · Cited by 40 · see citing works
“Earlier systematic reviews indicated that moderate to vigorous exercise reduces both positive and negative symptoms in schizophrenia (Dauwan et al., 2016; Firth et al., 2015).”
Background
Exercise Intervention in Individuals at Clinical High Risk for Psychosis: Benefits to Fitness, Symptoms, Hippocampal Volumes, and Functional Connectivity
Damme, K. S. F., Gupta, T., Ristanovic, I., Kimhy, D., Bryan, A. D., & Mittal, V. A. (2022) · Schizophrenia Bulletin · doi:10.1093/schbul/sbac084 · Cited by 35 · see citing works
Impact of Physical Exercise Alone or in Combination with Cognitive Remediation on Cognitive Functions in People with Schizophrenia: A Qualitative Critical Review
Deste, G., Corbo, D., Nibbio, G., Italia, M., Dell'Ovo, D., Calzavara‐Pinton, I., Lisoni, J., Barlati, S., Gasparotti, R., & Vita, A. (2023) · Brain Sciences · doi:10.3390/brainsci13020320 · Cited by 37 · see citing works
“, 2016 [31] Meta-analysis 17 (659) In one study, exercise improved verbal STM by 34% (p < 0.”
Effects of Exercise on Positive Symptoms, Negative Symptoms, and Depression in Patients with Schizophrenia: A Systematic Review and Meta-Analysis
Kim, M., Lee, Y., & Kang, H. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043719 · Cited by 36 · see citing works
Staff perspectives on the barriers and facilitators to exercise implementation in inpatient mental health services: A qualitative study
Ball, H., Yung, A. R., & Bucci, S. (2022) · Mental health and physical activity · doi:10.1016/j.mhpa.2022.100452 · Cited by 35 · see citing works
A Supervised Exercise Intervention for Youth at Risk for Psychosis
Dean, D. J., Bryan, A. D., Newberry, R. E., Gupta, T., Carol, E. E., & Mittal, V. A. (2017) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.16m11365 · Cited by 33 · see citing works
Conceptualization and characterization of “primary” and “secondary” cognitive impairment in schizophrenia
Vita, A., Nibbio, G., & Barlati, S. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.116126 · Cited by 34 · see citing works
“…represent another category of treatment that has shown some direct efficacy in improving cognitive performance in people living with schizophrenia (Dauwan et al., 2016; Firth et al., 2017; Saviola et al., 2023; Stubbs et al., 2018), and they can be easily integrated with other effective…”
Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment
Lotfi, Y., Rezazadeh, N., Moossavi, A., Haghgoo, H. A., Rostami, R., Bakhshi, E., Badfar, F., Moghadam, S. F., Sadeghi‐Firoozabadi, V., & Khodabandelou, Y. (2017) · Auris Nasus Larynx · doi:10.1016/j.anl.2017.01.011 · Cited by 35 · see citing works
The feasibility and acceptability of high-intensity interval training for adults with mental illness: A pilot study
Chapman, J. J., Coombes, J. S., Brown, W. J., Khan, A., Chamoli, S., Pachana, N. A., & Burton, N. W. (2017) · Mental health and physical activity · doi:10.1016/j.mhpa.2017.09.007 · Cited by 34 · see citing works
Effect of aerobic exercise combined with cognitive remediation on cortical thickness and prediction of social adaptation in patients with schizophrenia
Takahashi, S., Keeser, D., Rauchmann, B., Schneider-Axmann, T., Keller-Varady, K., Maurus, I., Dechent, P., Wobrock, T., Hasan, A., Schmitt, A., et al. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.11.004 · Cited by 34 · see citing works
Aerobic exercise in severe mental illness: requirements from the perspective of sports medicine
Falkai, P., Schmitt, A., Rosenbeiger, C. P., Maurus, I., Hattenkofer, L., Hasan, A., Malchow, B., Heim-Ohmayer, P., Halle, M., & Heitkamp, M. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-021-01360-x · Cited by 34 · see citing works
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Authors: Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E.
Affiliations: University Medical Center Utrecht (NL)
Corresponding author: Dauwan, Meenakshi
ORCID: Dauwan, Meenakshi
Begemann, Marieke J. H.
Heringa, Sophie M.
Sommer, Iris E.
Venue: Schizophrenia Bulletin
Publisher: Oxford University Press (OUP)
Published: 2015-11-07
Volume: 42
Issue: 3
Pages: 588-599
ISSN: 0586-7614 (ISSN-L)
1745-1701
DOI: 10.1093/schbul/sbv164
PMC: PMC4838091
OpenAlex: W2176833440
Cited by: 393
References: 151
Citations by year: 2026: 21 · 2025: 34 · 2024: 43 · 2023: 42 · 2022: 44 · 2021: 40 · 2020: 40 · 2019: 51 · 2018: 28 · 2017: 37 · 2016: 11 · 2015: 1 · 2013: 1
FWCI: 3.53
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
Locations: Schizophrenia Bulletin (publishedVersion, other-oa)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion, other-oa)
Utrecht University Repository (Utrecht University) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
HighWire Press Open Archive (submittedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Physiology › Physical Activity and Health
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords: physical activity, schizophrenia
MeSH terms: Depression, Exercise Therapy, Humans, Quality of Life, Schizophrenia, Outcome Assessment, Health Care, Cognitive Dysfunction

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Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis

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