Department of Psychiatry, University of Oxford, Oxford, UK; and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Br J Psychiatry. 2024 Sep;225(3):401-409. doi: 10.1192/bjp.2024.109.
Urbanisation is taking place worldwide and rates of mental illness are rising. There has been increasing interest in 'nature' and how it may benefit mental health and well-being.
To understand how the literature defines nature; what the characteristics of the nature intervention are; what mental health and well-being outcomes are being measured; and what the evidence shows, in regard to how nature affects the mental health and well-being of children and adolescents.
A meta-review was conducted, searching three databases for relevant primary and secondary studies, using key search terms including 'nature' and 'mental health' and 'mental well-being'. Inclusion criteria included published English-language studies on the child and adolescent population. Authors identified the highest quality evidence from studies meeting the inclusion criteria. Data were extracted and analysed using descriptive content analysis.
Sixteen systematic reviews, two scoping reviews and five good quality cohort studies were included. 'Nature' was conceptualised along a continuum (the 'nature research framework') into three categories: a human-designed environment with natural elements; a human-designed natural environment; and a natural environment. The nature 'intervention' falls into three areas (the 'nature intervention framework'): access, exposure and engagement with nature, with quantity and quality of nature relevant to all areas. Mental health and well-being outcomes fit along a continuum, with 'disorder' at one end and 'well-being' at the other. Nature appears to have a beneficial effect, but we cannot be certain of this.
Nature appears to have a beneficial effect on mental health and well-being of children and adolescents. Evidence is lacking on clinical populations, ethnically diverse populations and populations in low- and middle-income countries. Our results should be interpreted considering the limitations of the included studies and confidence in findings.
城市化正在全球范围内发生，精神疾病的发病率也在上升。人们对“自然”及其对心理健康和幸福感的影响越来越感兴趣。
了解文献如何定义自然；自然干预的特点是什么；正在测量哪些心理健康和幸福感结果；以及关于自然如何影响儿童和青少年心理健康和幸福感的证据表明了什么。
进行了一项元综述，在三个数据库中搜索了相关的主要和次要研究，使用了包括“自然”和“心理健康”和“心理幸福感”在内的关键搜索词。纳入标准包括针对儿童和青少年人群的已发表的英文研究。作者从符合纳入标准的研究中确定了最高质量的证据。使用描述性内容分析提取和分析数据。
纳入了 16 项系统评价、2 项范围综述和 5 项高质量队列研究。“自然”沿着一个连续体（“自然研究框架”）被概念化为三个类别：有人工设计的自然元素的环境；有人工设计的自然环境；和自然环境。自然“干预”分为三个领域（“自然干预框架”）：接触、暴露和参与自然，与所有领域相关的自然数量和质量。心理健康和幸福感结果沿着一个连续体排列，“障碍”在一端，“幸福感”在另一端。自然似乎对儿童和青少年的心理健康和幸福感有有益的影响，但我们不能确定这一点。
自然似乎对儿童和青少年的心理健康和幸福感有有益的影响。在临床人群、族裔多样化人群和中低收入国家人群中，证据不足。应考虑纳入研究的局限性和对研究结果的信心来解释我们的结果。
