Effects of Tai Chi and Qigong on physical function and psychiatric symptoms among individuals with mental illness: a systematic review and meta-analysis of randomized controlled trials

Abstract Background Tai Chi and Qigong (TCQ) can be a non-pharmacological intervention for individuals with mental illness, improving physical function and mental health. Purpose This meta-analysis investigated the effects of TCQ on physical function and psychiatric symptoms in adults with schizophrenia or mood disorders. Methods Randomized clinical trials on the effect of TCQ on physical function or psychiatric symptoms in individuals with mental illness, published in English, Korean, or Chinese, were included. A systematic search of 17 electronic databases up to September 2024 was conducted. The risk of bias was assessed using Cochrane RoB 2.0. Data were analyzed through meta-analysis, subgroup analysis, and meta-regression. Results Nineteen randomized studies (n = 1243, mean age 53 years) reported outcomes on physical function (k = 11) and psychiatric symptoms (k = 18). The risk of bias assessment showed that 21.1% of studies had a low risk, 73.7% had some concerns, and 5.3% had a high risk. TCQ significantly improved physical function (Hedges’ g = 0.53, 95% CI, 0.26-0.81) and psychiatric symptoms (Hedges’ g = 0.63, 95% CI, 0.41-0.85) in individuals with serious mental illness (SMI), regardless of intervention duration and comparison type. TCQ showed no significant effect on physical function in individuals with schizophrenia but demonstrated a significant moderate effect in those with mood disorders (Hedges’ g = 0.56, 95% CI, 0.32-0.80). TCQ significantly improved psychiatric symptoms in both groups (schizophrenia: Hedges’ g = 0.64, 95% CI, 0.26-1.02; mood disorders: Hedges’ g = 0.64, 95% CI, 0.33-0.96). Meta-regression indicated that the effects of TCQ on physical function covaries with those on psychiatric symptoms among individuals with SMI (Q = 21.43, df = 9, P = .011). Conclusions TCQ effectively enhances physical function and psychiatric symptoms in individuals with schizophrenia or mood disorders. These findings support TCQ as an effective non-pharmacological intervention for individuals with SMI. Further studies should explore the underlying mechanisms by which TCQ improves psychiatric symptoms through physical function, leading to the development of targeted intervention strategies in this population. *PROSPERO international prospective register of systematic reviews, registration ID CRD42024581253.