Psychotic Disorder
Conditions
Keywords
forest therapy, psychotic disorder, inflammation pathway, mindfulness
Brief summary
General Formulation Are there any changes in the inflammatory pathway and psychotic conditions in patients given Forest Therapy compared to conventional psychotic disorder therapy? Specific Are there any differences in the levels of inflammatory factors such as CRP, IL-6, and BDNF in patients given Forest Therapy compared to conventional psychotic disorder therapy? Are there differences in the psychotic conditions of patients, as assessed by PANSS, MADRSS, DASS-21, YMRS, Zung Anxiety Self Questionnaire, PSQI, and WHO-QL BREF, in patients receiving Forest Therapy compared to conventional psychotic disorder therapy? 1.3 Research Objectives 1.3.1 General Objective To determine the changes that occur in the inflammatory pathway and psychotic condition in patients receiving Forest Therapy compared to conventional psychotic disorder therapy. 1.3.2 Specific Objective To determine changes in the inflammatory pathway, particularly CRP, IL-6, and BDNF, in patients receiving Forest Therapy compared to conventional psychotic disorder therapy. To determine changes in psychotic conditions using the PANSS, BDI, MADRS, DASS-21, YMRS, Zung Anxiety Self Questionnaire, PSQI, and WHO-QL-BREF questionnaires in patients receiving Forest Therapy compared to conventional psychotic disorder therapy. To investigate the relationship between changes in inflammatory pathways and changes in psychotic conditions in patients receiving Forest Therapy compared to conventional psychotic disorder therapy. The research group will be divided into two groups using randomisation. The treatment group will receive forest therapy in the Mangkang forest from June to September 2025, with one session every two weeks for a total of eight sessions, while the control group will receive treatment for psychotic disorders as usual. Both groups will undergo psychometric testing, which includes assessment of psychotic symptoms, mood, insomnia, anxiety, stress levels, and quality of life. Blood samples will also be collected for complete blood count and inflammatory factor testing.
Detailed description
Intervention (8 sessions of 8 mg) Forest therapy will be provided in the form of mindful walking, forest bathing, mindful eating, meditation, and tree hugging.
Interventions
BEHAVIORALForest Therapy
The intervention group will receive standard psychotic therapy and participate in forest therapy activities consisting of mindful forest walking, sun bathing, forest hugging and meditation. These activities will be carried out over 8 sessions, with each session taking place once a week. The control group will be randomly divided into 4 small groups, each consisting of 10 participants. Each small group will be led by a trained therapist. These activities will last for 2 hours per session.
Sponsors
Natalia Dewi Wardani, MD
The Indonesian Red Cross
Indonesian Red Cross
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Masking description
Each patient was assigned an identification number, and the researcher who drew blood did not know whether the patient was in the treatment group or the control group
Intervention model description
The treatment group will receive forest therapy in the Mangkang forest from June to September 2025, with a frequency of once every two weeks for 8 sessions, while the control group will undergo psychotic disorder therapy as usual. Both groups will undergo psychometric testing, including assessment of psychotic symptoms, mood, insomnia, anxiety, stress levels, and quality of life. Blood samples will also be collected for complete blood count and inflammatory factor testing.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Aged 18-60 years old * Diagnosed with psychosis based on medical records at Dr. Kariadi General Hospital, Diponegoro National Hospital, Elisabeth Hospital Semarang and Banyumanik I Hospital Semarang * Minimum education level of junior high school (SMP) * Willing to participate in research
Exclusion criteria
* Consuming alcohol and immunosuppressants 1 month before sampling. Patients diagnosed with autoimmune disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CRP level in mg/L | 8 weeks | hs-CRP level in miligram/Liter, interval |
| BDNF levels in pg/ml | 8 weeks | BDNF levels in picogram/miiliter, interval |
| IL-6 level in pg/ml | 8 weeks | IL-6 levels in picogram/miiliter, interval |
| Psychotic Condition with Positive and Negative Syndrome Scale (PANSS) | 8 weeks | Psychotic Condition with Positive and Negative Syndrome Scale (PANSS) score, total score ranges from 30 to 210, with higher scores indicating greater symptom severity in schizophrenia patients. |
Countries
Indonesia
Contacts
PRINCIPAL_INVESTIGATORNatalia Dewi Wardani NDW Wardani, Doctoral
Medical Faculty Diponegoro University
Outcome results
None listed