Evidence map›Paper›PMID 40433171›Full record

ArticleFrontiers in psychiatry2025

Short-term effects of clown visits in child and adolescent psychiatric care: a pilot study on patient stress and mood outcomes and staff evaluations.

Amos-Silvio Erik Friedrich, Lorena Holzmeier, Johanna Ehlers, Simone Seebacher, Maggie Rössler, Nadine Skoluda, Urs Markus Nater, Martina Zemp

Abstract read
In one paragraph

Article in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Amos-Silvio Erik FriedrichDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Lorena HolzmeierDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Johanna EhlersDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Simone SeebacherDepartment of Research and Learning, RED NOSES Austria, Vienna, Austria.
Maggie RösslerDepartment of Research and Learning, RED NOSES International, Vienna, Austria.
Nadine SkoludaDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Urs Markus NaterDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.
Martina ZempDepartment of Clinical and Health Psychology, University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Clown visits are an effective intervention to alleviate patients' stress and anxiety in pediatric hospital settings. However, while children and adolescents in inpatient psychiatric treatment might uniquely benefit from healthcare clowning, little research has addressed the effectiveness of clown visits in this setting. Method: This pilot study examined the short-term effects of clown visits on psychological (self-reported stress and mood) and physiological (salivary cortisol) outcomes in 29 children and adolescents aged between 7 and 17 years (M = 12.69, SD = 2.90) in a noncontrolled repeated pre-post design over 4 weeks. In addition, 21 care staff members reported separately on their perceived impact of clown visits. Results: Self-reported stress levels of children and adolescents were decreased significantly from before to after clown visits, whereas salivary cortisol indicated a similar, but nonsignificant decrease. According to the Multidimensional Mood Questionnaire (MDMQ), patients showed significant improvements in energetic arousal, but there were no effects on mood valence and calmness. The effectiveness of the clown visits did not change over repeated visits. Care staff reported that clown visits had a positive impact on patients' and their own well-being, but their evaluations regarding their stress levels and work processes on the ward were mixed. Discussion: The present results provide preliminary evidence that the stress-reducing and energizing effects of clown visits, which previous studies have demonstrated in various pediatric settings, can also be transferred to the field of inpatient child and adolescent psychiatry. Mixed self- and work-related evaluations from care staff suggest that improvements in the implementation of clown visits could help eliminate disruptive elements of this intervention.

Indexed as

art-based interventioncortisolhealthcare clowninghumornursingpsychiatrystresswell-being

Identifiers

PMID40433171
PMCPMC12106319

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.