Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2013

Open Access 01-12-2013 | Research article

Yoga for schizophrenia: a systematic review and meta-analysis

Authors: Holger Cramer, Romy Lauche, Petra Klose, Jost Langhorst, Gustav Dobos

Published in: BMC Psychiatry | Issue 1/2013

Login to get access

Abstract

Background

The aim of this review was to systematically review and meta-analyze the effects of yoga on symptoms of schizophrenia, quality of life, function, and hospitalization in patients with schizophrenia.

Methods

MEDLINE/Pubmed, Scopus, the Cochrane Library, PsycInfo, and IndMED were screened through August 2012. Randomized controlled trials (RCTs) comparing yoga to usual care or non-pharmacological interventions were analyzed when they assessed symptoms or quality of life in patients with schizophrenia. Cognitive function, social function, hospitalization, and safety were defined as secondary outcomes. Risk of bias was assessed using the risk of bias tool recommended by the Cochrane Back Review Group. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Results

Five RCTs with a total of 337 patients were included; 2 RCTs had low risk of bias. Two RCTs compared yoga to usual care; 1 RCT compared yoga to exercise; and 2 3-arm RCTs compared yoga to usual care and exercise. No evidence was found for short-term effects of yoga compared to usual care on positive symptoms (SMD = -0.58; 95% CI -1.52 to 0.37; P = 0.23), or negative symptoms (SMD = -0.59; 95% CI -1.87 to 0.69; P = 0.36). Moderate evidence was found for short-term effects on quality of life compared to usual care (SMD = 2.28; 95% CI 0.42 to 4.14; P = 0.02). These effects were only present in studies with high risk of bias. No evidence was found for short-term effects on social function (SMD = 1.20; 95% CI -0.78 to 3.18; P = 0.23). Comparing yoga to exercise, no evidence was found for short-term effects on positive symptoms (SMD = -0.35; 95% CI -0.75 to 0.05; P = 0.09), negative symptoms (SMD = -0.28; 95% CI -1.42 to 0.86; P = 0.63), quality of life (SMD = 0.17; 95% CI -0.27 to 0.61; P = 0.45), or social function (SMD = 0.20; 95% CI -0.27 to 0.67; P = 0.41). Only 1 RCT reported adverse events.

Conclusions

This systematic review found only moderate evidence for short-term effects of yoga on quality of life. As these effects were not clearly distinguishable from bias and safety of the intervention was unclear, no recommendation can be made regarding yoga as a routine intervention for schizophrenia patients.
Appendix
Available only for authorised users
Literature
1.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders – DSM-IV-TR. 2000, Washington, DC: American Psychiatric Association, 4
2.
3.
Dominguez Mde G, Viechtbauer W, Simons CJ, van Os J, Krabbendam L: Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations. Psychol Bull. 2009, 135: 157-171.CrossRefPubMed
4.
Pitkänen A, Hätönen H, Kuosmanen L, Välimäki M: Individual quality of life of people with severe mental disorders. J Psychiatr Ment Health Nurs. 2009, 16: 3-9. 10.1111/j.1365-2850.2008.01308.x.CrossRefPubMed
5.
McCabe R, Saidi M, Priebe S: Patient-reported outcomes in schizophrenia. Br J Psychiatry Suppl. 2007, 50: s21-8.CrossRefPubMed
6.
Boyer L, Caqueo-Urízar A, Richieri R, Lancon C, Gutiérrez-Maldonado J, Auquier P: Quality of life among caregivers of patients with schizophrenia: a cross-cultural comparison of Chilean and French families. BMC Fam Pract. 2012, 13: 42-10.1186/1471-2296-13-42.CrossRefPubMedPubMedCentral
7.
Zeidler J, Slawik L, Fleischmann J, Greiner W: The costs of schizophrenia and predictors of hospitalisation from the statutory health insurance perspective. Health Econ Rev. 2012, 2: 9-10.1186/2191-1991-2-9.CrossRefPubMedPubMedCentral
8.
Wyatt RJ, Henter I, Leary MC, Taylor E: An economic evaluation of schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 1995, 30: 196-205.PubMedPubMedCentral
9.
Stahl SM, Buckley PF: Negative symptoms of schizophrenia: a problem that will not go away. Acta Psychiatr Scand. 2007, 115: 4-11.CrossRefPubMed
10.
Sheitman BB, Lieberman JA: The natural history and pathophysiology of treatment resistant schizophrenia. J Psychiatr Res. 1998, 32: 43-50.CrossRef
11.
Gorczynski P, Faulkner G: Exercise therapy for schizophrenia. Cochrane Database Syst Rev. 2010, 5: CD004412-PubMed
12.
Vancampfort D, Knapen J, Probst M, Scheewe T, Remans S, De Hert M: A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatr Scand. 2012, 125: 352-62. 10.1111/j.1600-0447.2011.01814.x.CrossRefPubMed
13.
Iyengar BKS: Light on Yoga. 1966, New York: Schocken Books
14.
Feuerstein G: The Yoga Tradition. 1998, Prescott: Hohm Press
15.
Cramer H, Lauche R, Haller H, Langhorst J, Dobos G, Berger B: “I’m more in balance.” A qualitative study of yoga for patients with chronic neck pain. J Altern Complement Med. in press
16.
Cramer H, Lange S, Klose P, Paul A, Dobos G: Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Canc. 2012, 12: 412-10.1186/1471-2407-12-412.CrossRef
17.
Smith KB, Pukall CF: An evidence-based review of yoga as a complementary intervention for patients with cancer. Psychooncology. 2009, 18: 465-475. 10.1002/pon.1411.CrossRefPubMed
18.
Cramer H, Lauche R, Langhorst J, Dobos G: Effectiveness of yoga for menopausal symptoms - a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2012, 2012: 863905-CrossRefPubMedPubMedCentral
19.
Büssing A, Ostermann T, Lüdtke R, Michalsen A: Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain. 2012, 13: 1-9.CrossRefPubMed
20.
Cramer H, Lauche R, Haller H, Dobos G: A systematic review and meta-analysis of yoga for low back pain. Clin J Pain. 2012, 10.1097/AJP.0b013e31825e1492.
21.
Pilkington K, Kirkwood G, Rampes H, Richardson J: Yoga for depression: the research evidence. J Affect Disord. 2005, 89: 13-24. 10.1016/j.jad.2005.08.013.CrossRefPubMed
22.
Li AW, Goldsmith CA: The effects of yoga on anxiety and stress. Altern Med Rev. 2012, 17: 21-35.PubMed
23.
Vancampfort D, Vansteelandt K, Scheewe T, Probst M, Knapen J, De Herdt A, De Hert M: Yoga in schizophrenia: a systematic review of randomised controlled trials. Acta Psychiatr Scand. 2012, 126: 12-20. 10.1111/j.1600-0447.2012.01865.x.CrossRefPubMed
24.
Moher D, Liberati A, Teztlaff J, Altman DG, The PRISMA Group: Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Ann Intern Med. 2009, 51: 1-7.
25.
26.
Spitzer RL, Endicott J, Robins L: Research Diagnostic Criteria for a Selected Group of Functional Disorders. 1977, New York: Biometrics Research Division, New York State Psychiatric Institue, 3
27.
World Health Organization: The ICD-10 Classification of Mental and Behavioural Disorders – Diagnostic Criteria for Research. 1993, Geneva: World Health Organization
28.
Baer RA: Mindfulness training as a clinical intervention: A conceptual and empirical review. Clin Psychol Sci Pract. 2003, 10: 125-143. 10.1093/clipsy.bpg015.CrossRef
29.
Overall JE, Gorham DL: The Brief Psychiatric Rating Scale. Psychol Rep. 1962, 10: 799-812. 10.2466/pr0.1962.10.3.799.CrossRef
30.
Kay SR, Fiszbein A, Opler LA: The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987, 13: 261-276. 10.1093/schbul/13.2.261.CrossRefPubMed
31.
Guy W: Clinical Global Impressions Scale (CGI). Handbook of Psychiatric Measures. Edited by: Rush AJ. 2000, Washington, DC: American Psychiatric Association, 100-102.
32.
Skevington SM, Lotfy M, O’Connell KA: The World Health Organization’s Whoqol-Bref quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004, 13: 299-310.CrossRefPubMed
33.
Nuechterlein KH, Green MF, Kern RS, Baade LE, Barch DM, Cohen JD, Essock S, Fenton WS, Frese FJ, Gold JM, Goldberg T, Heaton RK, Keefe RS, Kraemer H, Mesholam-Gately R, Seidman LJ, Stover E, Weinberger DR, Young AS, Zalcman S, Marder SR: The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. Am J Psychiatry. 2008, 165: 203-213. 10.1176/appi.ajp.2007.07010042.CrossRefPubMed
34.
Saraswat N, Rao K, Subbakrishna DK, Gangadhar BN: The Social Occupational Functioning Scale (SOFS): a brief measure of functional status in persons with schizophrenia. Schizophr Res. 2006, 31: 301-309.CrossRef
35.
36.
Furlan AD, Pennick V, Bombardier C, van Tulder M, Editorial Board, Cochrane Back Review Group: 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine. 2009, 34: 1929-1941. 10.1097/BRS.0b013e3181b1c99f.
37.
Cohen J: Statistical Power Analysis for the Behavioral Sciences. 1988, Hillsdale, NJ: Lawrence Erlbaum Associates
38.
van Tulder M, Furlan A, Bombardier C, Bouter L, Editorial Board of the Cochrane Collaboration Back Review Group: Updated method guidelines for systematic reviews in the cochrane collaboration back review group. Spine. 2003, 28: 1290-1299.
39.
40.
Egger M, Davey Smith G, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997, 315: 629-634. 10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral
41.
Behere RV, Arasappa R, Jagannathan A, Varambally S, Venkatasubramanian G, Thirthalli J, Subbakrishna DK, Nagendra HR, Gangadhar BN: Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatr Scand. 2011, 123: 147-53. 10.1111/j.1600-0447.2010.01605.x.CrossRefPubMed
42.
Varambally S, Gangadhar BN, Thirthalli J, Jagannathan A, Kumar S, Venkatasubramanian G, Muralidhar D, Subbakrishna DK, Nagendra HR: Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: Randomized controlled comparison with exercise and waitlist. Indian J Psychiatr. 54: 227-232.
43.
Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN: Yoga therapy as an add-on treatment in the management of patients with schizophrenia–a randomized controlled trial. Acta Psychiatr Scand. 2007, 116: 226-232. 10.1111/j.1600-0447.2007.01032.x.CrossRefPubMed
44.
Vancampfort D, De Hert M, Knapen J, Wampers M, Demunter H, Deckx S, Maurissen K, Probst M: State anxiety, psychological stress and positive well-being responses to yoga and aerobic exercise in people with schizophrenia: a pilot study. Disabil Rehabil. 2011, 33: 684-689. 10.3109/09638288.2010.509458.CrossRefPubMed
45.
Visceglia E, Lewis S: Yoga therapy as an adjunctive treatment for schizophrenia: a randomized, controlled pilot study. J Altern Complement Med. 2011, 17: 601-607. 10.1089/acm.2010.0075.CrossRefPubMed
46.
Xie J, Lin Y, Guo C, Chen F: Study on influences of yoga on quality of life of schizophrenic inpatients. J Nurs (China). 2006, 13: 9-11.
47.
Tsui MCM: Review of the effects of yoga on people with schizophrenia. Yoga Phys Ther. 2012, 2: S1-001.
48.
49.
Boehm K, Ostermann T, Milazzo S, Büssing A: Effects of yoga interventions on fatigue: a meta-analysis. Evid Based Complement Alternat Med. 2012, 2012: 124703-CrossRefPubMedPubMedCentral
50.
Schulz KF, Altman DG, Moher D, CONSORT Group: CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010, 152: 726-732.CrossRefPubMed
51.
Langer ÁI, Cangas AJ, Salcedo E, Fuentes B: Applying mindfulness therapy in a group of psychotic individuals: a controlled study. Behav Cogn Psychother. 2012, 40: 105-109. 10.1017/S1352465811000464.CrossRefPubMed
52.
Chadwick P, Hughes S, Russell D, Russell I, Dagnan D: Mindfulness groups for distressing voices and paranoia: a replication and randomized feasibility trial. Behav Cogn Psychother. 2009, 37: 403-412. 10.1017/S1352465809990166.CrossRefPubMed
53.
Thakkar KN, Nichols HS, McIntosh LG, Park S: Disturbances in body ownership in schizophrenia: evidence from the rubber hand illusion and case study of a spontaneous out-of-body experience. PLoS One. 2011, 6: e27089-10.1371/journal.pone.0027089.CrossRefPubMedPubMedCentral
Metadata
Title
Yoga for schizophrenia: a systematic review and meta-analysis
Authors
Holger Cramer
Romy Lauche
Petra Klose
Jost Langhorst
Gustav Dobos
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2013
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-13-32

Other articles of this Issue 1/2013

BMC Psychiatry 1/2013 Go to the issue

Research article

Brain responses to body image stimuli but not food are altered in women with bulimia nervosa

Research article

Reduced duration mismatch negativity in adolescents with psychotic symptoms: further evidence for mismatch negativity as a possible biomarker for vulnerability to psychosis

Research article

Dissociation of understanding from applying others’ false beliefs in remitted schizophrenia: evidence from a computerized referential communication task

Study protocol

The effectiveness of individual placement and support for people with mental illness new on social benefits: a study protocol

Research article

A three generation study of the mental health relationships between grandparents, parents and children

Research article

Schizotypy and personality profiles of Cluster A in a group of schizophrenic patients and their siblings