The Effectiveness of Forest Therapy on Psychotic Patients: Focusing on Changes in Inflammatory Pathways and The Psychotic Condition of Patients (FT)

Natalia Dewi Wardani, MD

Status: Completed

Conditions: Psychotic Disorder

Treatments: Behavioral: Forest Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07436481

48/UN7.F4/HK/IV/2025 (Other Grant/Funding Number)

085/EC/KEPK/FK-UNDIP/IV/2025

Details and patient eligibility

About

General Formulation Are there any changes in the inflammatory pathway and psychotic conditions in patients given Forest Therapy compared to conventional psychotic disorder therapy? Specific Are there any differences in the levels of inflammatory factors such as CRP, IL-6, and BDNF in patients given Forest Therapy compared to conventional psychotic disorder therapy? Are there differences in the psychotic conditions of patients, as assessed by PANSS, MADRSS, DASS-21, YMRS, Zung Anxiety Self Questionnaire, PSQI, and WHO-QL BREF, in patients receiving Forest Therapy compared to conventional psychotic disorder therapy?

1.3 Research Objectives 1.3.1 General Objective To determine the changes that occur in the inflammatory pathway and psychotic condition in patients receiving Forest Therapy compared to conventional psychotic disorder therapy.

1.3.2 Specific Objective To determine changes in the inflammatory pathway, particularly CRP, IL-6, and BDNF, in patients receiving Forest Therapy compared to conventional psychotic disorder therapy.

To determine changes in psychotic conditions using the PANSS, BDI, MADRS, DASS-21, YMRS, Zung Anxiety Self Questionnaire, PSQI, and WHO-QL-BREF questionnaires in patients receiving Forest Therapy compared to conventional psychotic disorder therapy.

To investigate the relationship between changes in inflammatory pathways and changes in psychotic conditions in patients receiving Forest Therapy compared to conventional psychotic disorder therapy.

The research group will be divided into two groups using randomisation. The treatment group will receive forest therapy in the Mangkang forest from June to September 2025, with one session every two weeks for a total of eight sessions, while the control group will receive treatment for psychotic disorders as usual. Both groups will undergo psychometric testing, which includes assessment of psychotic symptoms, mood, insomnia, anxiety, stress levels, and quality of life. Blood samples will also be collected for complete blood count and inflammatory factor testing.

Full description

Intervention (8 sessions of 8 mg) Forest therapy will be provided in the form of mindful walking, forest bathing, mindful eating, meditation, and tree hugging.

Enrollment: 80 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged 18-60 years old
• Diagnosed with psychosis based on medical records at Dr. Kariadi General Hospital, Diponegoro National Hospital, Elisabeth Hospital Semarang and Banyumanik I Hospital Semarang
• Minimum education level of junior high school (SMP)
• Willing to participate in research

Exclusion criteria

• Consuming alcohol and immunosuppressants 1 month before sampling. Patients diagnosed with autoimmune disorders

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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80 participants in 2 patient groups

Forest therapy group intervention

Experimental group

Description:

The intervention group will receive standard psychotic therapy and participate in forest therapy activities consisting of mindful forest walking, sun bathing, forest hugging and meditation. These activities will be carried out over 8 sessions, with each session taking place once a week. This group will be randomly divided into 4 small groups, each consisting of 10 participants. Each small group will be led by a trained therapist. These activities will last for 2 hours per session.

Treatment:

Behavioral: Forest Therapy

Control group

No Intervention group

Description:

The control group will only receive standard psychotic therapy.