Journal of Korean Society of Forest Science (한국산림과학회지)

Korean Society of Forest Science (한국산림과학회)
권호 표지

Synergistic Effect of Forest Environment and Therapeutic Program for the Treatment of Depression

산림활동이 우울증 환자들의 호전에 미치는 영향: 산림치유 프로그램 집단과 병원 프로그램 집단, 산림욕 집단, 대조군 비교 연구

  • Woo, Jong-Min (Stress Research Institute, Inje University) ;
  • Park, Sang Mi (Stress Research Institute, Inje University) ;
  • Lim, Seong Kyeon (Korean Employee Assistance Professional Association) ;
  • Kim, Won (Stress Research Institute, Inje University)
  • 우종민 (인제대학교 스트레스연구소) ;
  • 박상미 (인제대학교 스트레스연구소) ;
  • 임성견 ((사)한국EAP협회) ;
  • 김원 (인제대학교 스트레스연구소)
  • Published : 2012.12.31
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Abstract

This study was conducted to evaluate the effect of forest environment and therapeutic program to the patients with major depressive disorder in antidepressant medication. The first group participated the four sessions of therapeutic program in the forest environment ("forest therapy"), the second group did in the program in a hospital environment, the third group did merely walking in the forest ("forest bath"), and the last group was controls. All the participants was diagnosed with major depressive disorder and had been taking antidepressant medication longer than 3 months. Depressive symptoms were measured by the Hamilton Rating Scales for Depression(HRSD), Montgomery-Asberg Depressin Rating Scales(MADRS), Beck Depression Inventory(BDI), and general health perception was measured by Short Form Health Survey Questionnaire(SF-36). Heart rate variability(HRV) were also examined to observe the physiological parameters before and after the program. In the results, HRSD score of forest program group was significantly lower than controls after the program. MADRS score of forest therapy group and hospital program group was also significantly lower than controls after 4 sessions of the program. The remission rate defined as below 7 points in HRSD was higher in the forest therapy group, hospital program group, forest bath group, and controls in order. These results reveals that the therapeutic program performed in forest environment may improve unremitted depressive symptoms of patients with major depressive disorder. Although not significant, the forest therapy program showed better outcome than hosptial program and forest bath.

본 연구의 목적은 숲 환경을 이용한 주요우울장애의 정신사회적 치료 프로그램을 개발하여, 그 효과를 대조군 비교 연구를 통해 확인하는 것이다. 정신과 전문의에 의해 주요우울장애로 진단 받고 현재 정신과 외래에서 항우울제 약물치료 중인 사람들이 연구에 참여하였다. 이들은 각각 네 집단으로 나뉘어 세 집단은 각각 산림에서 시행한 치유 프로그램, 병원에서 시행한 치유 프로그램, 단순 산림욕에 참여하였고, 나머지 한 집단은 프로그램을 시행하지 않고 일반 진료만 받은 대조군이었다. 이들은 모두 프로그램 전후의 우울증상 변화, 생리적 지표 변화를 관찰하기 위해 Hamilton Rating Scales for Depression(HRSD), Montgomery-Asberg Depressin Rating Scales(MADRS), Beck Depression Inventory(BDI), Short Form Health Survey Questionnaire(SF-36), Heart Rate Variability(HRV)검사를 받았다. 연구 결과, 산림치유 프로그램 집단의 HRSD 점수가 대조군에 비해 유의하게 감소하였고, MADRS 점수는 산림치유 프로그램 집단, 병원 프로그램 집단이 대조군에 비해서 유의미한 호전을 보였다. HRSD 7점 이하로 정의되는 관해율은 산림치유 프로그램 집단이 가장 높았다. 또한 SF-36결과, 산림치유 프로그램 집단에서만 건강 상태와 관련된 삶의 질 수준이 유의미하게 증가하였고, Heart Rate Variability(HRV)에서도 생리적 이완감을 나타내는 HF가 유의하게 높아지는 결과를 보였다. 이 결과를 통하여 산림환경을 이용한 심리치료 프로그램을 외래 치료 중인 우울증 환자에게 적용했을 때 우울증 증상 개선에 도움이 됨을 알 수 있었다. 또한 통계적으로 유의하진 않지만, 우울증상 감소와 관해율에 있어서 산림치유 프로그램 집단, 병원 프로그램 집단, 산림욕 집단, 대조군 순으로 좋은 결과를 보였다.

Keywords

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