Abstract
Horticultural therapy is increasingly being used in the non-pharmacological treatment of patients with schizophrenia, with previous studies demonstrating its therapeutic effects. The healing outcomes are positively correlated with the settings of the intervention. This review aimed to evaluate the effectiveness of horticultural therapy on the symptoms, rehabilitation outcomes, quality of life, and social functioning in people with schizophrenia, and the different effectiveness in hospital and non-hospital environments. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. We researched studies through PubMed, Embase, the Cochrane Library, Science Direct, and the China National Knowledge Infrastructure. We included randomized controlled trials (RCTs) and quasi-experimental studies about horticultural therapy for people with schizophrenia, from January 2000 to December 2020, with a total of 23 studies involving 2024 people with schizophrenia included in this systematic review. This study provided evidence supporting the positive effect of horticultural therapy. This review demonstrated that non-hospital environments have a better therapeutic effect on all indicators than hospital environments. The results also demonstrated the effectiveness of horticultural therapy on symptoms, rehabilitation outcomes, quality of life, and social functioning in patients in hospital and non-hospital environments, providing further evidence-based support for landscape design.
Highlights
Schizophrenia is one of the most common severe mental disorders, being ranked among the top 20 causes of disability worldwide [1] and affecting 20 million people [2].People with schizophrenia often share common experiences, such as hallucinations, delusions, disturbances of emotions, and distortions in behavior and language, and they face2–3 times the risk of early death than the general population [3], qualifying the severity of this mental disorder
Schizophrenia is a debilitating disease because patients are cognitively impaired, which is often related to decreased executive functioning, eventually leading to severely impaired daily functioning and social interactions
For the purpose of this study, we evaluated the effects of horticultural therapy on schizophrenia through a systematic review
Summary
Schizophrenia is one of the most common severe mental disorders, being ranked among the top 20 causes of disability worldwide [1] and affecting 20 million people [2].People with schizophrenia often share common experiences, such as hallucinations, delusions, disturbances of emotions, and distortions in behavior and language, and they face2–3 times the risk of early death than the general population [3], qualifying the severity of this mental disorder. Schizophrenia is one of the most common severe mental disorders, being ranked among the top 20 causes of disability worldwide [1] and affecting 20 million people [2]. As schizophrenia is a chronic relapsing disease with a high recurrence rate and a high possibility of disability, the treatment of it has become one of the most challenging issues, affecting the everyday life of patients and their family financial status [4]. Recent evidence has demonstrated that non-pharmacological therapies are more desirable to alleviate symptoms of schizophrenia without producing side effects [6,7]. Horticultural therapy has received increasing attention as an effective and non-pharmacological intervention [8].
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