Group Yoga Practice Improves Inpatient Experience in Schizophrenia Hospitalization

Patients hospitalized for schizophrenia spectrum disorders (SSDs) reported significant improvements in experience and well-being following a yoga-based group intervention (YoGI). These findings were published in Frontiers in Psychiatry.

This study was conducted at the Charité-Universitätsmedizin in Germany. Inpatients (N=33) with SSDs were randomly assigned to receive treatment as usual with (n=19) or without (n=14) YoGI for 4 weeks. The YoGI intervention comprised a weekly 50-minute group class led by a clinical psychologist and a yoga teacher and was offered to all patients in the inpatient ward, regardless of treatment allocation. The study outcomes were the patient’s experience evaluated using semi-structured interviews.

The YoGI and control cohorts comprised 12 and 6 women, they had mean ages of 44.26 (SD, 15.23) and 48.07 (SD, 15.34) years, they had SSD durations of 11.63 (SD, 12.45) and 18.85 (SD, 12.15) years, and they were hospitalized for 8.58 (SD, 4.29) and 9 (SD, 6) weeks, respectively. The patients were diagnosed with schizophrenia (n=20), schizoaffective disorder (n=6), acute polymorphic psychotic disorder (n=4), delusional disorder (n=2), and schizotypal personality disorder (n=1).

A total of 5 participants did not complete the study due to premature discharge.

Prior to the intervention, patients thought yoga was beneficial and most hoped yoga would reduce their distress. However, some were skeptical about yoga, stating that doing a few exercises won’t suddenly change their health status.

After practicing YoGI, significant changes in narratives were observed, in which patients indicated they had learned to relax and felt physical and mental ease. Many specifically endorsed benefits from the final relaxation (savasana).

Some patients said they adopted the internalized self-regulatory techniques as a habitual coping mechanism for anxiety, sleep, distraction, and pain. Some patients said they assumed yoga poses when feeling distressed.

One of the most reported changes after YoGI was increased awareness of bodily cues, especially related to disembodiment, which is common in SSD. There was also an endorsement of the mind-body connection.

At baseline, many individuals reported a lack of self-confidence, fear of failure, and difficulty with self-motivation. After YoGI, participants felt that the encouragement from the yoga teacher to just try and that there was no need to be perfect, helped. Among patients with severe obesity, the mindful movement helped with self-kindness and acceptance.

The group delivery of YoGI helped patients to feel included and increased their confidence. Some patients said they arranged with fellow participants to practice yoga exercises outside YoGI class, fostering a feeling of community.

A subset of individuals (n=3) reported adverse effects. All these patients were new to yoga and reported difficulties with the introspective aspects of YoGI practice.

The major limitation of this study was the qualitative outcomes.

Study authors concluded, “YoGI–a low-threshold and low-cost group intervention of four weeks–led to increased wellbeing and substantial symptom improvements in study participants. The destigmatizing and normalizing approach of the intervention, which highlights inclusivity while tailoring the practice specifically to the needs of the targeted group, may have contributed to the improvements by reducing feelings of psychological stress, isolation, shame, and stigmatization.”