SynthesisBMJ open2025
Effect of nature-based health interventions for individuals diagnosed with anxiety, depression and/or experiencing stress-a systematic review and meta-analysis.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of therapeutic landscapes on the mental health of older adults: a systematic review.Frontiers in psychology · 2026Pooled it
- Article
- Clinicians' Perceptions of Nature-Based Interventions in Mental Health Care: A Qualitative Descriptive Study from Pakistan.Behavioral sciences (Basel, Switzerland) · 2026Article
- Connected by Nature: Nature-Based Intervention to Support Young Adults with Advanced Cancer.International journal of environmental research and public health · 2026Article
- Development of the Nature Impact Mental Health Intervention for People Experiencing Mild to Moderate Anxiety, Depression, and/or Stress-Co-Producing a Programme Theory and Logic Model.Healthcare (Basel, Switzerland) · 2026Article
- The 'Nature Impact' feasibility study protocol: a mixed methods feasibility study of a group- and nature-based health intervention for adults experiencing mild to moderate anxiety, depression and/or stress.Pilot and feasibility studies · 2026Article
- Nature-Based Interventions for Individuals with Psychiatric Disorders: A Mixed Methods Systematic Review with Random-Effects Meta-Analysis of Mental Health and Functional Outcomes.Behavioral sciences (Basel, Switzerland) · 2026Review
- Longitudinal Effects of Mindfulness Combined with Gratitude Touch on Anxiety, Depression, and Stress: A 12-Month Portable EEG-Based Study.Brain sciences · 2026Article
- Nature-Based Health Interventions for People with Mild to Moderate Anxiety, Depression, and/or Stress: Identifying Target Groups, Professionals, Mechanisms, and Outcomes Through a Delphi Study.International journal of environmental research and public health · 2026Article
- Psychological Integrity and Ecological Repair: The Impact on Planetary Public Mental Health (A Narrative Review).International journal of environmental research and public health · 2025Review
- Managing Late and Long-Term Effects Among Swedish Adolescents and Young Adults Affected by Cancer Following a Wilderness Intervention: Reconnecting with Self and Meaning Through Nature's Unconditional Presence - A Qualitative Study.Cancer control : journal of the Moffitt Cancer CenterArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe use of natural environments and nature activities as elements in the treatment and rehabilitation of mental health challenges is gaining international attention. The objective of the present review was to summarise the knowledge on the effects of nature-based health interventions (NBHIs) targeting individuals diagnosed with anxiety, depression and/or experiencing stress.
designSystematic review and meta-analyses. The quality and certainty of evidence were assessed using the SIGN and GRADE. DATA SOURCES: Searches were performed in Embase, MEDLINE, PsycINFO, CINAHL, Cochrane and Web of Science. ELIGIBILITY CRITERIA: (1) NBHIs, (2) Individuals with a diagnosis of mild to moderate anxiety, depression and/or experiencing stress, (3) Age of participating individuals: 18-84 years, (4) Study designs: randomised controlled trials, cohort studies, case-control studies and case-series studies and (5) Publication date: 2000-2024. DATA EXTRACTION AND SYNTHESIS: Screening, quality appraisal and certainty of evidence, assessed using SIGN and GRADE, were performed by two independent reviewers, except title screening. Meta-analyses were performed using random-effect models.
resultsNineteen articles were included, of which 14 were included in the meta-analyses. The articles showed substantial variation in design, interventions, settings and risk of bias, limiting the certainty of evidence according to GRADE. Participating in NBHIs led to a small to large effect in mental health with standardised mean changes of -0.80 (95% CI= (-1.56; -0.04)), -0.87 (95% CI= (-1.18; -0.56)), -0.32 (95% CI= (-0.74; 0.09)) and 0.58 (95% CI= (0.39; 0.77)) for anxiety, depression and stress scores and overall mental health scores, respectively.
conclusionsThis is the first systematic review examining the effect of NBHIs exclusively on individuals diagnosed with anxiety, depression and/or experiencing stress. Our findings suggest small to large improvements after participating in NBHIs. However, methodological limitations to the included articles necessitate cautious interpretation. PROSPERO REGISTRATION NUMBER: CRD42024516270.
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