14 Furthermore, physical activity in healthy aging populations is associated with improvement in cognitive functioning and depressive symptoms, delay in age-related cognitive decline and neurodegeneration. 13 The World Health Organization (WHO) 2009 14 reported that physical inactivity accounts for 27% of diabetes and 30% of ischemic heart diseases, whereas an active lifestyle reduces these risks, largely improving general health and wellness, and life expectancy. Physical inactivity has been described as the leading risk factor for global mortality.

12 Therefore, it is time to implement a therapy for patients with schizophrenia that decreases the negative symptoms and cognitive deficits, and also improves the functional and clinical outcome. 11 Saha et al found an all-cause standardized mortality ratio of 2.58 showing an increase in mortality in these patients over the last decades. 9, 10 These risk factors are major contributors of cardiovascular diseases in schizophrenia which in turn is associated with 2- to 3-fold higher mortality rate compared to the general population. 7, 8 Furthermore, reduced physical capacity in patients with schizophrenia is strongly related to negative and cognitive symptoms. 6 In addition, antipsychotics result in the side effects weight gain and metabolic syndrome. 4, 5 Treatment with antipsychotic drugs, applied as first line therapy, typically result in reduction in positive symptoms with minimal to no effects on negative and cognitive symptoms. 3 Higher negative and cognitive symptoms are significantly associated with poorer functional outcome. 2 Negative and cognitive symptoms, emerging in the pre-psychotic stage, appear to be related. 1 This disorder is characterized by (1) positive symptoms such as hallucinations and delusions, (2) negative symptoms including affective flattening, alogia and avolition, and (3) neurocognitive deficits including perception, memory, and attention, among others. Schizophrenia, a severe psychiatric disorder, affects approximately 24 million people worldwide. Psychopathology, functioning, cognition, yoga, aerobic exercise Introduction

Comprehensive meta analysis version 2