Abstract
Mental health is reportedly influenced by the presence of green and blue space in residential areas, but scientific evidence of a relation to psychotic disorders is scant. We put two hypotheses to the test: first, compared to the general population, psychiatric patients live in neighborhoods with less green and blue space; second, the amount of green and blue space is negatively associated with the duration of hospital admission. The study population consisted of 623 patients with psychotic disorders who had been admitted to the psychiatric ward of an academic hospital in Utrecht, The Netherlands from 2008 to 2016. Recovery was measured by length of stay. Structured patient data was linked to socio-economic status and the amount of green and blue space in the residential area. Associations were assessed by means of regression models controlling for confounding factors. Compared to the general population, psychiatric patients had a significantly lower amount of green space in their neighborhood. This result was not confirmed for blue space. Furthermore, no significant associations were found between green and blue space and the duration of hospital stay. In conclusion, previous studies focusing on other mental disorders, like anxiety or depression, found positive mental health effects of green and blue space in the neighborhood. We were not able to confirm significant effects among our study population on duration of admission, however. Future research focusing on psychotic patients could investigate the influence of exposure to green and blue space on other influences and outcomes on mental health.
Highlights
A high burden of disease is caused by mental disorders [1], those in the psychotic spectrum, which account for a large share of the disease-adjusted life years attributed to mental disorders [2]
The study population consisted of patients with a psychotic disorder who had been admitted to the inpatient department of psychiatry, University Medical Center (UMC) Utrecht, between January 2008 and
Independent of the fitted model, we found no statistical evidence that either green space or blue space is correlated with our response variable, namely length of stay of patients diagnosed with schizophrenia and other psychotic disorders
Summary
A high burden of disease is caused by mental disorders [1], those in the psychotic spectrum, which account for a large share of the disease-adjusted life years attributed to mental disorders [2]. Biological, psychological, and social factors, which are often associated with psychotic disorders, environmental factors may be involved [3]. Many studies have examined the relation of green and blue space with general mental health [3,4,5,6,7], but research into the effect of green and blue space on specific mental disorders is scarce. Exposure to green space was found to improve mental health [8,9,10,11]. In comparison to the built environment [12], green space is thought to improve social cohesion [13], reduce stress, facilitate restoration of attention problems and fatigue, Int. J. Public Health 2018, 15, 2195; doi:10.3390/ijerph15102195 www.mdpi.com/journal/ijerph
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