Efficacy of Adjuvant Yoga Therapy for Cognition in Schizophrenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Background: It is well-known that negative and cognitive symptoms in schizophrenia are challenging to treat with conventional psychotropics. Hence, various mind–body interventions like yoga have been brought into the modern scientific realm to investigate for possible benefits. Although several studies have been done using yoga as an intervention for cognition in schizophrenia, the results have been inconclusive. In this study, we systematically reviewed and performed meta-analyses of the eligible studies to investigate the efficacy of yoga as adjuvant therapy for cognition in the schizophrenia population. Methodology: After registration of the protocol in PROSPERO (CRD42024504319), electronic databases such as PubMed, MEDLINE, PsycINFO, Scopus, Cochrane Library, ClinicalTrials.gov, and gray literature were searched for randomized controlled trials from their date of inception till March 2024, with appropriate search terms. Covidence and Microsoft Excel for data extraction, Cochrane tool for risk of bias assessment version 2, and RevMan version 5.4.1 for data analysis were used. Results: Of 182 studies found through database search, five articles were included for systematic review and two for the meta-analysis, with a pooled sample size of 76 patients. A systematic review of five articles showed high risk in two articles and low risk in three articles. Meta-analysis showed no significant effect of yoga on cognition (standardized mean difference 0.17, 95% confidence interval: −0.28 to 0.63, P = 0.46). Conclusion: The results of the meta-analysis should be interpreted with caution owing to the low power, small sample size, methodological limitations in the included studies, and hence high likelihood of type II error. There is a need for more studies with rigorous methodology involving yoga for cognition in schizophrenia.