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

Author

Listed:
  • Poung-Sik Yeon

    (Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea)

  • Jin-Young Jeon

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Myeong-Seo Jung

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Gyeong-Min Min

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Ga-Yeon Kim

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Kyung-Mi Han

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Min-Ja Shin

    (Graduated Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Korea)

  • Seong-Hee Jo

    (National Center for Forest Therapy, Yeongju 36043, Korea)

  • Jin-Gun Kim

    (Korea Forest Therapy Forum Incorporated Association, Cheongju 28644, Korea)

  • Won-Sop Shin

    (Department of Forest Sciences, Chungbuk National University, Cheongju 28644, Korea)

Abstract

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.

Suggested Citation

  • Poung-Sik Yeon & Jin-Young Jeon & Myeong-Seo Jung & Gyeong-Min Min & Ga-Yeon Kim & Kyung-Mi Han & Min-Ja Shin & Seong-Hee Jo & Jin-Gun Kim & Won-Sop Shin, 2021. "Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 18(23), pages 1-27, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12685-:d:692892
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    5. Yunjeong Yi & Eunju Seo & Jiyeon An, 2022. "Does Forest Therapy Have Physio-Psychological Benefits? A Systematic Review and Meta-Analysis of Randomized Controlled Trials," IJERPH, MDPI, vol. 19(17), pages 1-21, August.
    6. Elena Bermejo-Martins & María Pueyo-Garrigues & María Casas & Raúl Bermejo-Orduna & Ana Villarroya, 2022. "A Forest Bathing Intervention in Adults with Intellectual Disabilities: A Feasibility Study Protocol," IJERPH, MDPI, vol. 19(20), pages 1-12, October.
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    9. Jaewoo Kang & Jeongho Choi & Kyoungmin Lee, 2024. "Development of an Evaluation Index for Forest Therapy Environments," IJERPH, MDPI, vol. 21(2), pages 1-19, January.

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