Clinical effects of a yoga-based intervention for patients with schizophrenia - A six-month randomized controlled trial

Background: Yoga has shown promise as an add-on therapy for patients with schizophrenia. However, most studies have been short-term, with methodological limitations. Methods: We conducted a six-month parallel-group randomized-controlled trial (with rater blinding) to evaluate the effectiveness of a yoga-based intervention in improving symptoms and quality of life in patients with schizophrenia. We recruited 110 patients from an urban tertiary hospital and a semi-urban community centre who met DSM 5 criteria for schizophrenia and were on stable medication for at least six weeks. Participants were randomly assigned to either yoga add-on therapy (YT) or treatment-as-usual (TAU) groups. Clinical assessments were conducted at baseline and at one, three and six months. The primary outcome was changes in positive/ negative symptom scores and secondary outcomes included changes in quality of life, perceived stress and sociooccupational functioning. Results: Intention to treat analysis with a longitudinal mixed model approach revealed a significant group-bytime interaction with the YT group showing medium effect improvements in negative symptoms (eta 2p = 0.06) and small effect improvements in positive symptoms (eta 2p = 0.012), WHOQOL-BREF quality of life [psychological well-being (eta 2p = 0.015) and environmental health (eta 2p = 0.048)] when compared to TAU. The patients successfully learned and performed yoga practices without reporting any significant adverse effects. Discussion: Our findings suggest that yoga-based intervention may be a valuable adjuvant therapy for medicationstabilized patients with schizophrenia, especially in ameliorating negative symptoms and enhancing quality of life. Future controlled trials, including active physical interventions, are crucial to validate yoga's efficacy, optimize clinical use, and elucidate underlying mechanisms.