Effects of Mobile-Based Forest-Therapy Programs Using Urban Forests for Symptoms of Depressed Patients.

This study investigated the effect of mobile-based forest therapy programs on relieving depression to advance non-pharmaceutical treatments for patients with depression. The effects of depression, sleep quality, and physical symptoms were analyzed as measurement indicators to determine the effectiveness of symptom relief in patients with depression. This study used a randomized controlled experiment design. Participants were randomly assigned, and a total of 44 people participated, including 23 in the experimental group and 21 in the control group. The experimental group participated in a mobile-based forest therapy program (participating once a week) for six sessions. As a result of this study, depression patients who participated in the mobile-based forest therapy program conducted in urban forests showed a significant reduction in MADRS (from 21.48 ± 4.05 to 7.13 ± 7.00). In addition, PSQI (from 19.78 ± 7.69 to 14.48 ± 8.11) and PHQ-15 (from 9.87 ± 5.08 to 7.57 ± 5.03) were also found to significantly improve symptoms. This suggests that forest-therapy programs using mobile applications can be applied as non-pharmaceutical interventions to relieve symptoms in patients with depression.

Benefits of Urban Forest Healing Program on Depression and Anxiety Symptoms in Depressive Patients.

Depression is considered a widespread mental health problem worldwide. Moreover, anxiety symptoms are very closely related to depression in patients, and it is known that the coexistence rate of depression and anxiety diagnosed simultaneously is high. Treatment and preventive management of depression and anxiety are essential for public health. Forest healing is attracting attention as a form of low-cost preventive medicine that is safe and has no side effects. However, although the physiological and psychological effects have been scientifically proven, it is insufficient to reveal a direct relationship between forest healing and depression. This study investigated the benefits of an urban forest healing program on depression and anxiety symptoms in depressive disorders. We employed a randomized controlled trial design. Forty-seven depressive patients were randomly divided into an urban forest healing program group and a control group. Measures included the Montgomery-Asberg depression rating scale (MADRS), the Hamilton Anxiety Rating Scale (HARS), and the State-Trait Anxiety Inventory (STAI) questionnaires. Our results revealed that the combination of general treatment and forest healing programs for patients with depression is more effective in improving depression and anxiety than routine treatment alone. We expect our work to serve as a starting point for more sophisticated research discussing the availability of non-pharmacological treatments in forest healing.

The Factors and Relationships Influencing Forest Hiking Exercise Characteristics after COVID-19 Occurrence: At Seoul Metropolitan Area and in Hikers' 20s and 30s.

The growing interest and usage of green space during the pandemic relates to why greenery increases enjoyment of daily life and alleviates troubles arising from infectious periods. However, it is necessary to understand what reactions to the degree of COVID-19's spread were expressed in hiking exercise characteristics (hiking frequency, actual movement distance, average speed, total exercise time). To understand the progress of forest usage behavior during the pandemic, we analyzed factors influencing hiking exercise characteristics and relationships between those factors and hiking exercise characteristics. Hiking record data were obtained (2019-2020) from the workout app "Tranggle" pertaining to hikers in their 20s and 30s who visited the 13 mountains in the Seoul Metropolitan Area most frequently. The differences in hiking exercise characteristics (2019 data subtracted from 2020) were linked with factor data that could be related to them, including the degree of COVID-19's spread (Rt). To explore relationships between hiking exercise characteristics and factors, we developed four models with a linear mixed model. We found that Rt, week, weekdays/weekends, and PM10 contributed to explaining the hiking exercise characteristics' differences. As a result of this analysis, the degree of COVID-19's spread (Rt) affected hiking frequency; the week affected hiking frequency and actual movement distance; weekdays or weekends affected hiking frequency, actual movement distance, average speed, and total exercise time; and PM10 affected hiking frequency. These findings indicate that hiking was an alternative way for those looking for a new strategy to replace lost opportunities for physical activity. Therefore, we conclude that it is necessary to induce the usage of green space so that many people can take advantage of the functions and benefits of greenery, which stood out during the pandemic era.

Effects of Forest Therapy on Psychological Improvement in Middle-aged Women in Korea.

OBJECTIVES: Women experience more stress in middle age than in other periods of their lives. Therefore, health management programs that enable middle-aged women to cope with and manage stress are needed. This study investigated the psychological effects of a meditation-focused forest therapy program among 53 middle-aged women living in urban areas in Korea. METHODS: Participants were divided into 2 groups: one group underwent the program for 3 days in a forest, followed by 3 days in an urban environment, and the other group underwent the program for 3 days in the urban environment, followed by 3 days in the forest. The psychological effects of the forest therapy program were evaluated using the Profile of Mood States-Brief (POMS-B). Differences in mood state before and after the program conducted in the forest (experimental group) and in the urban environment (control group) were evaluated using the paired-samples t-test. RESULTS: The program in the forest significantly reduced tension, depression, anger, fatigue, and confusion among the domains of the POMS-B. The program in the urban area significantly reduced tension, but not depression, anger, fatigue, or confusion. CONCLUSIONS: Meditation-focused forest therapy programs are expected to contribute to promoting psychological health and enhancing the quality of life of middle-aged women.

Effects of Urban Forest Therapy Program on Depression Patients.

Depression is a common serious mental health condition that can have negative personal and social consequences, and managing it is critical for treating depression patients. Forest therapy is emerging as a promising non-pharmacological intervention to improve mental health. However, although the effectiveness of forest therapy programs using forests far from the city has been proven, it is not well known that urban forests can be easily accessed in daily life. Therefore, this study aimed to examine the effects of an urban forest therapy program on depression symptoms, sleep quality, and somatization symptoms of depression patients. To evaluate this, a randomized controlled trial (RCT) design was employed. A total of 47 depression patients participated in this study (22 in the urban forest therapy program group and 25 in the control group). The Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HRSD), the Pittsburgh Sleep Quality Index (PSQI), and the Patient Health Questionnaire-15 (PHQ-15) were administered to each participant to assess the effects of the urban forest therapy program. The results of this study revealed that depression patients in the urban forest therapy program had significantly alleviated depression symptoms and improved sleep quality and somatization symptoms compared to the control group. In conclusion, this study demonstrates the possibility that the urban forest therapy program could be used as an effective non-pharmacological treatment to alleviate depression disorder.

The Effect of Forest Video Using Virtual Reality on the Stress Reduction of University Students Focused on C University in Korea.

The purpose of this study is to study the effect of forest videos using virtual reality (VR) on the stress of college students. The study subjects were 60 college students who watched two-dimensional (2D) and VR videos, and we compared their control heart rate variability (HRV) and electroencephalogram (EEG). As a result, it was found that the VR group had a positive effect on high frequency (HF), standard deviation of all NN intervals (SDNN), and root-mean-square of successive differences (RMSSD) compared with the control group, and the VR group had a positive effect on HF compared with the 2D group. Second, EEG, a physiological indicator, showed statistical differences in Relative Alpha Power (RA), Relative Beta Power (RB), and Ratio of SMR-Mid Beta to Theta (RSMT) in VR groups in intra-group analysis. Among them, it was investigated that watching forest videos on VR became a state of concentration and immersion due to the increase in RSMT. As a result of the above, it was investigated that forest videos using VR had a positive effect on the physiological stress on college students. Therefore, it is expected that a positive effect will occur if VR is used as an alternative to stress management for college students.

Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to summarize the effects of forest therapy on depression and anxiety using data obtained from randomized controlled trials (RCTs) and quasi-experimental studies. We searched SCOPUS, PubMed, MEDLINE(EBSCO), Web of science, Embase, Korean Studies Information Service System, Research Information Sharing Service, and DBpia to identify relevant studies published from January 1990 to December 2020 and identified 20 relevant studies for the synthesis. The methodological quality of eligible primary studies was assessed by ROB 2.0 and ROBINS-I. Most primary studies were conducted in the Republic of Korea except for one study in Poland. Overall, forest therapy significantly improved depression (Hedges's g = 1.133; 95% confidence interval (CI): -1.491 to -0.775) and anxiety (Hedges's g = 1.715; 95% CI: -2.519 to -0.912). The quality assessment resulted in five RCTs that raised potential concerns in three and high risk in two. Fifteen quasi-experimental studies raised high for nine quasi-experimental studies and moderate for six studies. In conclusion, forest therapy is preventive management and non-pharmacologic treatment to improve depression and anxiety. However, the included studies lacked methodological rigor and required more comprehensive geographic application. Future research needs to determine optimal forest characteristics and systematic activities that can maximize the improvement of depression and anxiety.

The Physio-Psychological Effect of Forest Therapy Programs on Juvenile Probationers.

The study aimed to investigate the psychological and physiological effects of forest therapy programs on adolescents under probation. Fifty probationary teenagers from the Ministry of Gyeonggi Justice Compliance Support Center participated in the study. The study explored the effectiveness of a nonrandomized control group pretest-posttest design forest therapy program. The forest therapy program was conducted for two days and one night for the experimental groups (N = 33), who participated in the forest therapy program, and the control group (N = 17), who received two days of attendance center orders program in the lecture room of the Ministry of Gyeonggi Justice Compliance Support Center. As a result, adolescents under probation who participated in forest therapy programs had a beneficial effect on psychological well-being (K-WBMMS) and HRV's HF (high frequency) and LF/HF (A ratio of Low Frequency to High Frequency) compared to those who received the general attendance center orders program. These results support that forest therapy programs play a positive role in the psychological and physiological effects of probationary adolescents and can affect the diversity of rehabilitation programs for probationary adolescents.