Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain.
Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 46010 Valencia, Spain.
Int J Environ Res Public Health. 2022 Apr 22;19(9):5094. doi: 10.3390/ijerph19095094.
Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.
近年来，人们的生活方式发生了变化，更多地与屏幕接触，同时与自然环境的接触减少。越来越多的人意识到，接触自然和使用电子屏幕与抑郁有关。到目前为止，还没有同时审查这些环境生活方式如何影响抑郁症状和障碍。本综述的目的是收集有关自然接触和屏幕时间在抑郁中的作用的文献。重点是研究具有明确抑郁诊断的临床患者样本以及该领域使用的不同方法。第二个目标是为临床实践和研究提出一个议程。如果研究评估了有临床诊断的抑郁症患者的抑郁症状，则将其纳入研究。综述使用三个科学数据库对截至 2021 年 12 月发表的文献进行了概述。几项涉及自然接触的干预措施已显示出对抑郁症状和与情绪相关的测量指标的积极影响。最一致的发现表明，在自然环境中散步可能会降低临床抑郁症患者的抑郁症状。较少研究的干预措施，如在森林中进行的心理治疗或通过虚拟现实接触自然环境，也可能有效。相比之下，在有临床抑郁症的患者中，对屏幕时间的观察性研究较少，实验研究也较少。因此，还讨论了实践和研究建议。关于屏幕时间的研究较少，干预措施多种多样，方法学上也存在许多不足，这使得我们无法在该领域得出结论。需要更多高质量的实验研究来确定在临床抑郁症中具有已证明疗效的干预措施。在现阶段，为患有抑郁症的个体制定这些生活方式的实践指南和建议还为时过早。目前的研究结果可以作为制定基于自然接触和屏幕时间的策略的基础，以针对临床抑郁症。
