The Effectiveness of Forest Therapy on Psychotic Patients: Focusing on Changes in Inflammatory Pathways and The Psychotic Condition of Patients (FT)

February 26, 2026 updated by: Natalia Dewi Wardani, MD

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Actual)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Indonesia
    • Central Java
      • Semarang, Central Java, Indonesia, 50131
        • Kendal Forest- PMI Semarang

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Forest therapy group intervention
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. This 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.
Behavioral: Forest 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.
Other Names:
  • Shinrin-yoku
No Intervention: Control group
The control group will only receive standard psychotic therapy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
CRP level in mg/L
Time Frame: 8 weeks
hs-CRP level in miligram/Liter, interval
8 weeks
BDNF levels in pg/ml
Time Frame: 8 weeks
BDNF levels in picogram/miiliter, interval
8 weeks
IL-6 level in pg/ml
Time Frame: 8 weeks
IL-6 levels in picogram/miiliter, interval
8 weeks
Psychotic Condition with Positive and Negative Syndrome Scale (PANSS)
Time Frame: 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.
8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Natalia Dewi Wardani, MD

Collaborators

Indonesian Red Cross
The Indonesian Red Cross

Investigators

  • Principal Investigator: Natalia Dewi Wardani NDW Wardani, Doctoral, Medical Faculty Diponegoro University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2025

Primary Completion (Actual)

September 1, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

February 21, 2026

First Submitted That Met QC Criteria

February 21, 2026

First Posted (Actual)

February 27, 2026

Study Record Updates

Last Update Posted (Actual)

March 2, 2026

Last Update Submitted That Met QC Criteria

February 26, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 085/EC/KEPK/FK-UNDIP/IV/2025
  • 48/UN7.F4/HK/IV/2025 (Other Grant/Funding Number: HIBAH FK UNDIP 2025)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The data are not publicly available due to privacy or ethical restrictions. The dataset involves sensitive information about mental health, and sharing it publicly would compromise participant confidentiality as per the ethical approval obtained.

Study Data/Documents

  1. Informed Consent Form
    Information identifier: pdf file
    Information comments: klik the link to get informed consent file in English

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Psychotic Disorder

Clinical Trials on Forest Therapy

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Mexico

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe