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Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis
Open accessAbstract
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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“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]
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“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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“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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“Whilst the data are encouraging for core psychiatric symptoms [34,69], this finding requires replication in large, controlled trials.”
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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“These results align with a meta-analysis indicating exercise and yoga to alleviate depressive symptoms in persons with schizophrenia.62”
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Items 301–393 of 393
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“Moreover, meta-analytic studies have shown that exercise therapy is effective on psychiatric symptoms, cognitive symptoms, and overall quality of life in Sz patients [38,39].”
Virtual cycling as an exercise intervention in forensic psychiatry: A qualitative study
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“15,16 The main barrier to physical activity is a lack of motivation and medical side effects that often include sedation and decreased metabolism, leading to rapid weight gain.”
Roell, L., Maurus, I., Schmitt, A., & Falkai, P. (2025) · Neuropsychiatrie · doi:10.1007/s40211-025-00552-4 · Cited by 1
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“In a meta-analysis study evaluates the effect of physical activity in patients with schizophrenia and states that physical activity has positive effects on functionality, clinical symptoms and depression levels (8).”
Background1/6 Les activités physiques et sportives adaptées
Becas, D., Bechetoille, B., & Seyroux, J.-R. (2019) · Soins Psychiatrie · doi:10.1016/j.spsy.2018.11.010 · Cited by 1
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Sporttherapie bei Schizophrenie
Keller-Varady, K., Falkai, P., & Malchow, B. (2017) · PSYCH up2date · doi:10.1055/s-0042-118429
“Eine Metaanalyse zeigte, dass sowohl Yoga als auch aerobes Ausdauertraining die Lebensqualität von Patienten mit schizophrenen Psychosen verbessern können [26].”
BackgroundInfluentialEs lohnt, bei Schizophrenien frühzeitig zu behandeln
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“Metaanalysen konnten bestätigen, dass aerobes Ausdauertraining Positiv-, Negativ- und globale Symptome, depressive Verstimmung und die Alltagsfunktion gemessen mit der Global Assessment of Functioning (GAF) bei Menschen mit Schizophrenie verbessert (14).”
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Erdogan, Y., Yamaner, F., & Karadere, M. E. (2018) · SHS Web of Conferences · doi:10.1051/shsconf/20184801027
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Psychotherapeutische und psychosoziale Interventionen (Modul 4b)
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Os impactos neurobiológicos e neurocognitivos da atividade física nos pacientes com esquizofrenia
Ferreira, L. F. M., Saldanha, A. C. L., Cherem, A. C. T., Santos, A. L. D., Freitas, A. M. M. D., Campos, M. V. L., & Robis, K. P. (2020) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e4916.2020
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Richter, D., Riedel-Heller, S. G., Breilmann, J., Hasan, A., Falkai, P., Kilian, R., Allgöwer, A., Ajayi, K., Baumgärtner, J., Brieger, P., et al. (2022) · Fortschritte der Neurologie · Psychiatrie · doi:10.1055/a-1854-5174
“…höheren Teilnahme an Aktivitäten mit körperlicher Be-tätigung als auch mit einer besseren aeroben Leistungsfähigkeit gegenüber einer entsprechenden Patientengruppe mit niedrigerem GAF verknüpft war [17, 18]; ähnliche Ergebnisse konnten auch für Personen mit bipolaren Störungen gezeigt werden [19].”
BackgroundVilamala, S., Puig, M., Ochoa, S., Martin-Martínez, J. R., Hernández, A., Balsera, J., Verdaguer-Rodríguez, M., Villellas, R., Arenas, O., & García‐Franco, M. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.14013
Managing Metabolic Adverse Effects
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Motor function in early onset schizophrenia—A 2‐year follow‐up study
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Pratique du sport et Psychiatrie
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“Physical activity also has advantages for those with schizophrenia beyond physical health– including improvements in mental health symptoms, cognition, and functioning (Dauwan et al., 2016; Firth et al., 2017; Shimada et al., 2022).”
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InfluentialRoty, R., Lepers, R., & Mater, A. (2025) · European Journal of Applied Physiology · doi:10.1007/s00421-025-05902-2
“These locomotor exercises promote neuroplastic effects (Clos et al. 2021), reduce low-back pain (Brumitt et al. 2013), and improve the quality of life in people with schizophrenia (Dauwan et al. 2016) and the elderly (Fleg 2012).”
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“Although exercise has been shown to have positive effects on depression (Schuch et al., 2016), and cognitive function in schizophrenia (Dauwan et al., 2016, Firth et al., 2017, Stubbs et al., 2018), as well as a possibly reduced desire for drugs (Zschucke et al., 2012), patients with psychotic…”
Activité physique et santé mentale
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Tang, W., Wei, Z., Guan, C., Yuan, J., Sun, L., Zhang, X., & Cui, H. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-07823-6
“In patients with schizophrenia, physical activity is closely associated with symptom severity, cognitive abilities, and comorbid conditions [67].”
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Physical activity in the treatment of schizophrenia
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Effects of exercise-based rehabilitation training in schizophrenia patients
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Effectiveness of aerobic exercise in psychiatric disorders: Naturopathy has its say
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Epilepsy with Centrotemporal Spikes: Advances in Cognitive and Motor Interventions
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Assessment and treatment of negative symptoms in psychotic disorders – a national clinical guideline
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“The EPA guidance cites meta-analytic evidence [73,74] demonstrating moderate beneficial effects (Hedges’ g = 0.43– 0.49) across heterogeneous interventions, including mind-body and aerobic training.”
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“Exercise has been shown to positively affect both physical and mental health outcomes (Dauwan et al., 2016; Maurus et al., 2023), and aerobic training is already recommended in the German clinical guidelines for schizophrenia (Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik…”
A Pilot Feasibility Study of a Virtual Lifestyle Intervention for Individuals with Schizophrenia
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Bayesian network analysis uncovers physical activity–mood dynamics: Insights from the DiAPAson study
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“The positive PA – mood association observed in HC was attenuated and more variable among participants with SSD, consistent with prior evidence of reduced mood reactivity and motivational impairments in this population (Dauwan et al., 2015; Firth et al., 2016; Kimhy et al., 2015).”
Exercise interventions for cognitive impairment in schizophrenia: An umbrella review
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Metadata
- Authors
- Dauwan, M., Begemann, M. J. H., Heringa, S. M., & Sommer, I. E.
- Affiliations
- University Medical Center Utrecht (NL)
- Corresponding author
- Dauwan, Meenakshi
- 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
- 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
- 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 › Public Health, Environmental and Occupational Health › 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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