Integrating mind–body exercises for stress in schizophrenia: A systematic review of randomized controlled trials

Introduction: Schizophrenia is a chronic mental illness characterized by psychobiological vulnerability, where stress can exacerbate symptoms and precipitate relapses. Mind-body exercises have gained attention as non-pharmacological interventions that may support symptom management and improve clinical outcomes. Aim: To evaluate the impact of mind-body exercises on stress-related outcomes in individuals with schizophrenia. Design: A systematic review. Methods: A systematic search was conducted across six electronic databases to identify eligible studies published from database inception to February 13, 2025. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Results: A total of 140 articles were identified through our search of six electronic databases. Ultimately, six randomized controlled trials involving 433 participants were included. While most studies reported significant within-group improvements in stress-related outcomes following mind-body exercise interventions, only two studies demonstrated significant between-group differences. Discussion: Mind-body exercises may be beneficial in reducing stress among patients with schizophrenia, offering psychological benefits despite limited evidence of superiority over control groups. Implications for practice: Mind-body exercises may serve as a safe, complementary therapy for stress management in schizophrenia care. Integration into nursing-led treatment programs could support emotional well-being and reduce relapse risk, especially when reinforced through ongoing patient interaction and coaching. Trial and protocol registration: This study was registered in PROSPERO (CRD42025638156).