title: Exercise Improves Clinical Symptoms, Quality of Life, Global Functioning, and Depression in Schizophrenia: A Systematic Review and Meta-analysis.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus, VU University Medical Center, Amsterdam, The Netherlands m.dauwan-3@umcutrecht.nl.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Dauwan
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;
authors.forename: Marieke J H
authors.initials: MJ
authors.lastname: Begemann
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;
authors.forename: Sophie M
authors.initials: SM
authors.lastname: Heringa
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands;
authors.forename: Iris E
authors.initials: IE
authors.lastname: Sommer
mesh_terms: D060825:Cognitive Dysfunction / Q000209:etiology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012559:Schizophrenia / Q000150:complications / Q000534:rehabilitation*
keywords: aerobic exercise; cognition; functioning; psychopathology; yoga