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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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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]
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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]
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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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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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