Abstract
Prior reviews show that certain complementary and alternative practices are promising for patients with schizophrenia. The aim of this study is to review the outcome literature on intervention studies using integrative body–mind–spirit (I-BMS) practices on schizophrenia. This is an outcome literature review of randomized controlled trials (RCTs) on I-BMS practices from 2004 to 2016. The review used a modified Delphi List to assess methodological rigor and the California Evidence-Based Clearinghouse Scientific Rating Scale to evaluate the level of research support for each identified I-BMS practice. This review identified 13 RCTs of I-BMS practices, including mindfulness interventions (5), yoga (3), tai-chi (2), and relaxation (3). I-BMS practices were effective with medium to large effect sizes for alleviating symptoms, decreasing anxiety and stress, improving insight and mindfulness, subjective well-being and social/occupational functioning, as well as decreasing the frequency and duration of re-hospitalization. This review expands the knowledge base of treatment effectiveness pertaining to patients with schizophrenia.
Similar content being viewed by others
References
Aleman, A., Lincoln, T. M., Bruggeman, R., Melle, I., Arends, J., Arango, C., et al. (2016). Treatment of negative symptoms: Where do we stand, and where do we go? Schizophrenia Research. https://doi.org/10.1016/j.schres.2016.05.015.
Amador, X. F., & David, A. S. (Eds.). (1998). Insight and psychosis. New York, NY: The Oxford University Press.
Author et al. (2009).
Barbato, A., WHO Nations for Mental Health Initiative, & World Health Organization. (1997). Schizophrenia and public health. Geneva: World Health Organization.
Behere, R. V., Arasappa, R., Jagannathan, A., Varambally, S., Venkatasubramanian, G., Thirthalli, J., et al. (2011). Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatrica Scandinavica, 123(2), 147–153.
Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training: A manual for the helping professions. Champaign, IL: Research Press.
Bronson, D. E., & Davis, T. S. (2011). Finding and evaluating evidence: Systematic reviews and evidence-based practice. New York, NY: Oxford University Press.
California Evidence-Based Clearinghouse. (2016). The California Evidence-Based Clearinghouse for Child Welfare Scientific Rating Scale. Retrieved from http://www.cebc4cw.org/ratings/scientific-rating-scale/.
Chadwick, P., Hughes, S., Russell, D., Russell, I., & Dagnan, D. (2009). Mindfulness groups for distressing voices and paranoia: A replication and randomized feasibility trial. Behavioural and Cognitive Psychotherapy, 37(04), 403–412.
Chen, W. C., Chu, H., Lu, R. B., Chou, Y. H., Chen, C. H., Chang, Y. C., et al. (2009). Efficacy of progressive muscle relaxation training in reducing anxiety in patients with acute schizophrenia. Journal of Clinical Nursing, 18(15), 2187–2196.
Chien, W. T., & Lee, I. Y. (2013). The mindfulness-based psychoeducation program for Chinese patients with schizophrenia. Psychiatric Services, 64(4), 376–379.
Chien, W. T., & Thompson, D. R. (2014). Effects of a mindfulness-based psychoeducation programme for Chinese patients with schizophrenia: 2-year follow-up. The British Journal of Psychiatry, 205, 52–59.
Chong, H. Y., Chaiyakunapruk, N., Wu, D. B. C., Lee, K. K. C., & Chiou, C. F. (2014). Global economic burden of schizophrenia: A systematic review. Value Health, 7(17), A767.
Curley, J. P., Jensen, C. L., Mashoodh, R., & Champagne, F. A. (2011). Social influences on neurobiology and behavior: Epigenetic effects during development. Psychoneuroendocrinology, 36(3), 352–371.
Dauwan, M., Begemann, M. J., Heringa, S. M., & Sommer, I. E. (2016). Exercise improves clinical symptoms, quality of life, global functioning, and depression in schizophrenia: A systematic review and meta-analysis. Schizophrenia Bulletin, 42(3), 588–599.
Duraiswamy, G., Thirthalli, J., Nagendra, H. R., & Gangadhar, B. N. (2007). Yoga therapy as an add-on treatment in the management of patients with schizophrenia—A randomized controlled trial. Acta Psychiatrica Scandinavica, 116(3), 226–232.
Froeliger, B., Garland, E. L., & McClernon, F. J. (2012). Yoga meditation practitioners exhibit greater gray matter volume and fewer reported cognitive failures: Results of a preliminary voxel-based morphometric analysis. Evidence-Based Complementary and Alternative Medicine. https://doi.org/10.1155/2012/821307.
Garland, E. L., & Howard, M. O. (2009). Neuroplasticity, psychosocial genomics, and the biopsychosocial paradigm in the 21st century. Health and Social Work, 34(3), 191–199.
Georgiev, A., Probst, M., Hert, M., Genova, V., Tonkova, A., & Vancampfort, D. (2012). Acute effects of progressive muscle relaxation on state anxiety and subjective well-being in chronic Bulgarian patients with schizophrenia. Psychiatria Danubina, 24(4), 367–372.
Helgason, C., & Sarris, J. (2013). Mind-body medicine for schizophrenia and psychotic disorders: A review of the evidence. Clinical schizophrenia & related psychoses, 7(3), 138–148.
Ho, R. T., Au Yeung, F. S., Lo, P. H., Law, K. Y., Wong, K. O., Cheung, I. K., et al. (2012). Tai-chi for residential patients with schizophrenia on movement coordination, negative symptoms, and functioning: A pilot randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2012, 923925.
Ho, R. T., Fong, T. C., Wan, A. H., Au-Yeung, F. S., Wong, C. P., Ng, W. Y., et al. (2016). A randomized controlled trial on the psychophysiological effects of physical exercise and Tai-chi in patients with chronic schizophrenia. Schizophrenia Research, 171(1), 42–49.
Insel, T. R. (2010). Rethinking schizophrenia. Nature, 468(7321), 187–193.
Irwin, M. R. (2008). Human psychoneuroimmunology: 20 years of discovery. Brain, Behavior, and Immunity, 22(2), 129–139.
Jacobson, E. (1939). Variation of blood pressure with skeletal muscle tension and relaxation. Annals of Internal Medicine, 12(8), 1194–1212.
Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B., & Dixon, L. B. (2010). The schizophrenia patient outcomes research team (PORT): Updated treatment recommendations 2009. Schizophrenia Bulletin, 36(1), 94–103.
Krupchanka, D., & Katliar, M. (2016). The role of insight in moderating the association between depressive symptoms in people with schizophrenia and stigma among their nearest relatives: A pilot study. Schizophrenia Bulletin, 42(3), 600–607.
Langer, Á. I., Cangas, A. J., Salcedo, E., & Fuentes, B. (2012). Applying mindfulness therapy in a group of psychotic individuals: A controlled study. Behavioural and Cognitive Psychotherapy, 40(01), 105–109.
Lee, M. Y., Wang, X., Liu, C., Raheim, S., & Tebb, S. (2018). Outcome literature review of integrative body–mind–spirit practices for mental health conditions. Social Work Research, 42(3), 251–266.
Lincoln, T. M., Lüllmann, E., & Rief, W. (2007). Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophrenia bulletin, 33(6), 1324–1342.
National Institute of Mental Health. (2016). Schizophrenia. Retrieved from http://www.nimh.nih.gov/health/publications/schizophrenia-booklet-12-2015/index.shtml
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to relapse prevention. New York: Guilford.
Van Os, J., & Kapur, S. (2009). Schizophrenia. Lancet, 374, 635–645.
Vancampfort, D., De Hert, M., Knapen, J., Maurissen, K., Raepsaet, J., Deckx, S., et al. (2011). Effects of progressive muscle relaxation on state anxiety and subjective well-being in people with schizophrenia: A randomized controlled trial. Clinical Rehabilitation, 25(6), 567–575.
Vancampfort, D., Vansteelandt, K., Scheewe, T., Probst, M., Knapen, J., De Herdt, A., et al. (2012). Yoga in schizophrenia: A systematic review of randomised controlled trials. Acta Psychiatrica Scandinavica, 126(1), 12–20.
Verhagen, A. P., de Vet, H. C., de Bie, R. A., Kessels, A. G., Boers, M., Bouter, L. M., et al. (1998). The Delphi list: A criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Journal of Clinical Epidemiology, 51(12), 1235–1241.
Visceglia, E., & Lewis, S. (2011). Yoga therapy as an adjunctive treatment for schizophrenia: A randomized, controlled pilot study. The Journal of Alternative and Complementary Medicine, 17(7), 601–607.
Wang, L. Q., Chien, W. T., Yip, L. K., & Karatzias, T. (2016). A randomized controlled trial of a mindfulness-based intervention program for people with schizophrenia: 6-month follow-up. Neuropsychiatric Disease and Treatment, 12, 3097–3110.
Funding
This research is supported by 2013–2014 National Association of Deans and Director in Social Work (NADD) Development Fund in Graduate Social Work Education received by Dr. Mo Yee Lee.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Ethical Approval
This article does not contain any studies with animals and human participants performed by any of the authors.
Informed Consent
The authors understand that the paper is subject to editing for clarity, elimination of redundancies, and conformity with APA style.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Wang, X., Beauchemin, J., Liu, C. et al. Integrative Body–Mind–Spirit (I-BMS) Practices for Schizophrenia: An Outcome Literature Review on Randomized Controlled Trials. Community Ment Health J 55, 1135–1146 (2019). https://doi.org/10.1007/s10597-019-00409-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-019-00409-5