{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:01:20Z","timestamp":1792789280309,"version":"4.5.0"},"reference-count":69,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vehicle Racing Commemorative Foundation of Japan"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: It has been reported that forest bathing significantly reduced negative emotions and increased the positive feelings in both healthy males and females, as well as increasing blood serotonin in healthy males, indicating the potential for a beneficial effect on depressive status. However, an improvement effect of forest bathing on participants with depression has not been reported so far. Therefore, in order to fill this gap, this study examined the effect of forest bathing on depression in female participants with depression\/depressive tendencies. Methods: Thirty-one females aged 40.1 \u00b1 2.4 years with depression\/depressive tendencies were recruited after obtaining informed consent. The study employed a randomized crossover design to compare forest bathing with city walking. They participated in day trips to a Japanese cypress forest park and to a city area of Nagano Prefecture as a control in June 2023. On both trips, they walked 2.5 km (for 90 min) in the morning and afternoon, respectively, for a total of 5.0 km per day. Blood samples were taken at 4 pm for the measurements before forest bathing on the first day and after the walking in forest and unban sites on the second and third days, at the same hospital. Concentrations of oxytocin, IGF-1, serotonin and lactic acid in blood were measured. SDS scores were calculated and the POMS test and questionnaires for subjective fatigue symptoms and sleep quality were administered before and after each trip. Temperature, humidity and illuminance were also measured in the forest and urban environments. The Nippon Medical School Central Ethics Committee approved this study. Results: Forest bathing significantly decreased SDS scores compared to city walk and the baseline, and the effect lasted for one week after forest bathing. Forest bathing also significantly increased the concentrations of blood serotonin in participants who were not taking antidepressants, significantly increased the levels of oxytocin and IGF-1 in blood, significantly increased the scores for positive feelings, and reduced the scores for negative emotions compared with city walking in the POMS test. In addition, forest bathing reduced subjective fatigue symptoms and improved sleep quality. Conclusions: These findings provided scientific evidence to contribute to understanding forest bathing as a potential intervention for preventing depression, and future research on males should further explore these effects.<\/jats:p>","DOI":"10.3390\/diseases13040100","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T10:54:48Z","timestamp":1743159288000},"page":"100","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impacts of Forest Bathing (Shinrin-Yoku) in Female Participants with Depression\/Depressive Tendencies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2660-1464","authenticated-orcid":false,"given":"Qing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0136-854X","authenticated-orcid":false,"given":"Norimasa","family":"Takayama","sequence":"additional","affiliation":[{"name":"Forestry and Forest Products Research Institute, Forest Research and Management Organization, Tsukuba 300-1244, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Katsumata","sequence":"additional","affiliation":[{"name":"Nursing School, Nippon Medical School, Chiba 270-1613, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takayama","sequence":"additional","affiliation":[{"name":"Takayama Orthopedic Clinic, Tokyo 617-0814, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukako","family":"Kimura","sequence":"additional","affiliation":[{"name":"itswellness org, Tokyo 305-8687, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeyoshi","family":"Kumeda","sequence":"additional","affiliation":[{"name":"Nagano Prefectural Kiso Hospital, Nagano 397-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Miura","sequence":"additional","affiliation":[{"name":"Agematsu Town Office, Nagano 399-5601, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Ichimiya","sequence":"additional","affiliation":[{"name":"Ichimiya Mental Clinic, Tokyo 110-0005, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruei","family":"Tan","sequence":"additional","affiliation":[{"name":"Tan Clinic, Tokyo 214-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Hojo Clinic Mizonokuchi, Kawasaki 213-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-0120","authenticated-orcid":false,"given":"Amane","family":"Tateno","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunemi","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0544-325X","authenticated-orcid":false,"given":"Yoichiro","family":"Aoyagi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Imai","sequence":"additional","affiliation":[{"name":"INFOM (International Society of Nature and Forest Medicine), Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1265\/ehpm.22-00160","article-title":"Effects of forest environment (Shinrin-yoku\/Forest bathing) on health promotion and disease prevention\u2014The Establishment of \u2018Forest Medicine\u2019","volume":"27","author":"Li","year":"2022","journal-title":"Environ. Health Prev. Med."},{"key":"ref_2","unstructured":"Li, Q. (2012). Forest Medicine, Nova Science Publishers, Inc.. Available online: https:\/\/novapublishers.com\/shop\/forest-medicine\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/039463200802100113","article-title":"Visiting a forest, but not a city, increases human natural killer activity and expression of anti-cancer proteins","volume":"21","author":"Li","year":"2008","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_4","first-page":"45","article-title":"A forest bathing trip increases human natural killer activity and expression of anti-cancer proteins in female subjects","volume":"22","author":"Li","year":"2008","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s12199-009-0086-9","article-title":"The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): Evidence from field experiments in 24 forests across Japan","volume":"15","author":"Park","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1007\/s00421-011-1918-z","article-title":"Acute effects of walking in forest environments on cardiovascular and metabolic parameters","volume":"111","author":"Li","year":"2011","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s12199-009-0091-z","article-title":"Trends in research related to \u201cShinrin-yoku\u201d (taking in the forest atmosphere or forest bathing) in Japan","volume":"15","author":"Tsunetsugu","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1177\/147323000603400204","article-title":"The effects of exercise in forest and urban environments on sympathetic nervous activity of normal young adults","volume":"34","author":"Yamaguchi","year":"2006","journal-title":"J. Int. Med. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2114\/jpa2.26.135","article-title":"Physiological effects of Shinrin-yoku (taking in the atmosphere of the forest) in an old-growth broadleaf forest in Yamagata Prefecture, Japan","volume":"26","author":"Tsunetsugu","year":"2007","journal-title":"J. Physiol. Anthropol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s12199-019-0800-1","article-title":"A comparative study of the physiological and psychological effects of forest bathing (Shinrin-yoku) on working age people with and without depressive tendencies","volume":"24","author":"Furuyashiki","year":"2019","journal-title":"Environ. Health Prev. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yu, C.P., Lin, C.M., Tsai, M.J., Tsai, Y.C., and Chen, C.Y. (2017). Effects of Short Forest Bathing Program on Autonomic Nervous System Activity and Mood States in Middle-Aged and Elderly Individuals. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14080897"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.puhe.2010.09.005","article-title":"Effect of forest bathing on physiological and psychological responses in young Japanese male subjects","volume":"125","author":"Lee","year":"2011","journal-title":"Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Queirolo, L., Fazia, T., Roccon, A., Pistollato, E., Gatti, L., Bernardinelli, L., Zanette, G., and Berrino, F. (2024). Effects of forest bathing (Shinrin-yoku) in stressed people. Front. Psychol., 15.","DOI":"10.3389\/fpsyg.2024.1458418"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1265\/ehpm.22-00136","article-title":"Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males","volume":"27","author":"Li","year":"2022","journal-title":"Environ. Health Prev. Med."},{"key":"ref_15","unstructured":"World Health Organization (2025, March 14). Depression. Available online: https:\/\/www.who.int\/health-topics\/depression."},{"key":"ref_16","unstructured":"Institute of Health Metrics and Evaluation (2025, March 14). Global Health Data Exchange (GHDx). Available online: http:\/\/ghdx.healthdata.org\/gbd-results-tool?params=gbd-api-2019-permalink\/d780dffbe8a381b25e1416884959e88b."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.jad.2014.12.031","article-title":"High serum uric acid level in adolescent depressive patients","volume":"174","author":"Tao","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"77","DOI":"10.17116\/jnevro201811808277","article-title":"Interferon-induced depression and peripheral blood serotonin in patients with multiple sclerosis","volume":"118","author":"Baidina","year":"2018","journal-title":"Zhurnal Nevrol. I Psikhiatrii Im. S.S. Korsakova"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/hup.2525","article-title":"Evaluation of interleukin-6 and serotonin as biomarkers to predict response to fluoxetine","volume":"31","author":"Manoharan","year":"2016","journal-title":"Hum. Psychopharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Jaworek, A.K., Jaworek, M., Makara-Studzi\u0144ska, M., Szafraniec, K., Doniec, Z., Szepietowski, J., Wojas-Pelc, A., and Pokorski, M. (2020). Depression and Serum Content of Serotonin in Adult Patients with Atopic Dermatitis. Advances in Experimental Medicine and Biology, Springer.","DOI":"10.1007\/5584_2019_470"},{"key":"ref_21","first-page":"371","article-title":"Relation of serum cholesterol, lipid, serotonin and tryptophan levels to severity of depression and to suicide attempts","volume":"25","year":"2000","journal-title":"Psychiatry Neurosci."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Moroianu, L.A., Cecilia, C., Ardeleanu, V., Pantea Stoian, A., Cristescu, V., Barbu, R.E., and Moroianu, M. (2022). Clinical Study of Serum Serotonin as a Screening Marker for Anxiety and Depression in Patients with Type 2 Diabetes. Medicina, 58.","DOI":"10.3390\/medicina58050652"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/978-981-32-9705-0_7","article-title":"The Role of the Oxytocin System in Anxiety Disorders","volume":"1191","author":"Yoon","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.psychres.2008.06.034","article-title":"Serum oxytocin levels in patients with depression and the effects of gender and antidepressant treatment","volume":"169","author":"Ozsoy","year":"2009","journal-title":"Psychiatry Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Veiga, L., Carolino, E., Santos, I., Ver\u00edssimo, C., Almeida, A., Grilo, A., Brito, M., and Santos, M.C. (2022). Depressive symptomatology, temperament and oxytocin serum levels in a sample of healthy female university students. BMC Psychol., 10.","DOI":"10.1186\/s40359-022-00744-5"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jpsychires.2013.12.012","article-title":"Plasma oxytocin concentrations are lower in depressed vs. healthy control women and are independent of cortisol","volume":"51","author":"Yuen","year":"2014","journal-title":"J. Psychiatr. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2890","DOI":"10.1016\/j.psyneuen.2013.07.017","article-title":"May oxytocin be a trait marker for bipolar disorder?","volume":"38","author":"Turan","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1523\/JNEUROSCI.21-05-01628.2001","article-title":"Circulating insulin-like growth factor I mediates exercise-induced increases in the number of new neurons in the adult hippocampus","volume":"21","author":"Trejo","year":"2001","journal-title":"J. Neurosci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1100\/tsw.2006.22","article-title":"Aspects of growth hormone and insulin-like growth factor-I related to neuroprotection, regeneration, and functional plasticity in the adult brain","volume":"6","author":"Aberg","year":"2006","journal-title":"Sci. World J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"8270","DOI":"10.1523\/JNEUROSCI.5855-12.2013","article-title":"Serotonin is required for exercise-induced adult hippocampal neurogenesis","volume":"33","author":"Klempin","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"114","DOI":"10.31662\/jmaj.2023-0010","article-title":"Molecular Mechanisms of Exercise-induced Hippocampal Neurogenesis and Antidepressant Effects","volume":"6","author":"Kondo","year":"2023","journal-title":"JMA J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/pcn.13200","article-title":"Association between the serum insulin-like growth factor-1 concentration in the first trimester of pregnancy and postpartum depression","volume":"75","author":"Adachi","year":"2021","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_33","first-page":"151","article-title":"Evaluation of the Effects of High Intensity Interval Training on Cytokine Levels and Clinical Course in Treatment of Opioid Use Disorder","volume":"31","author":"Vardar","year":"2020","journal-title":"Turk. Psikiyatri. Derg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1001\/archpsyc.1965.01730060026004","article-title":"Self-rating depression scale in an outpatient clinic. Further validation of the SDS","volume":"13","author":"Zung","year":"1965","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1176\/ajp.154.12.1641","article-title":"Psychopathology in women and men: Focus on female hormones","volume":"154","author":"Seeman","year":"1997","journal-title":"Am. J. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1001\/archpsyc.1977.01770130100011","article-title":"Sex differences and the epidemiology of depression","volume":"34","author":"Weissman","year":"1977","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1037\/0033-2909.101.2.259","article-title":"Sex differences in unipolar depression: Evidence and theory","volume":"101","year":"1987","journal-title":"Psychol. Bull."},{"key":"ref_38","unstructured":"Brody, D.J., Pratt, L., and Hughes, J. (2025, March 14). Prevalence of Depression Among Adults Aged 20 and over: United States, 2013\u20132016, Available online: https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db303.htm."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.parkreldis.2007.05.004","article-title":"Characteristics of depression in Parkinson\u2019s disease: Evaluating with Zung\u2019s Self-Rating Depression Scale","volume":"14","author":"Kanda","year":"2008","journal-title":"Park. Relat. Disord."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"23","DOI":"10.5387\/fms.2016-21","article-title":"Emotional disturbance assessed by the Self-Rating Depression Scale test is associated with mortality among Japanese Hemodialysis patients","volume":"64","author":"Kazama","year":"2018","journal-title":"Fukushima J. Med. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/PSY.0b013e31821df0c2","article-title":"Evaluation of enzyme immunoassay and radioimmunoassay methods for the measurement of plasma oxytocin","volume":"73","author":"Szeto","year":"2011","journal-title":"Psychosom. Med."},{"key":"ref_42","first-page":"401","article-title":"Standardization of revised version of OSA sleep inventory for middle age and aged","volume":"10","author":"Yamamoto","year":"1999","journal-title":"Brain Sci. Ment. Disord."},{"key":"ref_43","unstructured":"Japan Organization of Better Sleep (2023, April 12). OSA Sleep Inventory MA Version. Available online: https:\/\/www.jobs.gr.jp\/osa_ma.html."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"102976","DOI":"10.1016\/j.ctim.2023.102976","article-title":"Relieving psychological stress and improving sleep quality by bergamot essential oil use before bedtime and upon awakening: A randomized crossover trial","volume":"77","author":"Wakui","year":"2023","journal-title":"Complement. Ther. Med."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Kim, H., Kim, J., Ju, H.J., Jang, B.J., Wang, T.K., and Kim, Y.I. (2020). Effect of Forest Therapy for Menopausal Women with Insomnia. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186548"},{"key":"ref_46","unstructured":"Li, Q. (2012). Chapter 8. Effect of forest bathing on sleep and physical activity. Forest Medicine, Nova Science Publishers, Inc.. Available online: https:\/\/novapublishers.com\/shop\/forest-medicine\/."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.pnpbp.2003.11.018","article-title":"Central monoamines and their role in major depression","volume":"28","author":"Elhwuegi","year":"2004","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jad.2019.02.063","article-title":"Plasma serotonin levels are associated with antidepressant response to SSRIs","volume":"250","author":"Holck","year":"2019","journal-title":"J. Afect. Disord."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s002130050924","article-title":"Plasma serotonin level after 1 day of fluoxetine treatment: A biological predictor for antidepressant response?","volume":"143","author":"Alvarez","year":"1999","journal-title":"Psychopharmacology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1038\/mp.2016.6","article-title":"TSPAN5, ERICH3 and selective serotonin reuptake inhibitors in major depressive disorder: Pharmacometabolomics-informed pharmacogenomics","volume":"21","author":"Gupta","year":"2016","journal-title":"Mol. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"12421","DOI":"10.1038\/s41598-021-91626-0","article-title":"Social dialogue triggers biobehavioral synchrony of partners\u2019 endocrine response via sex-specific, hormone-specific, attachment-specific mechanisms","volume":"11","author":"Djalovski","year":"2021","journal-title":"Sci Rep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1124\/pr.120.019398","article-title":"Is Oxytocin \u201cNature\u2019s Medicine\u201d?","volume":"72","author":"Carter","year":"2020","journal-title":"Pharmacol. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.jad.2020.01.155","article-title":"The relationship between sleep efficiency and clinical symptoms is mediated by brain function in major depressive disorder","volume":"266","author":"Zhu","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jpsychires.2020.01.015","article-title":"Major depressive disorder and insomnia: Exploring a hypothesis of a common neurological basis using waking and sleep-derived heart rate variability","volume":"123","author":"Eddie","year":"2020","journal-title":"J. Psychiatr. Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Morita, E., Imai, M., Okawa, M., Miyaura, T., and Miyazaki, S. (2011). A before and after comparison of the effects of forest walking on the sleep of a community-based sample of people with sleep complaints. Biopsychosoc. Med., 5.","DOI":"10.1186\/1751-0759-5-13"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Morita, E., Kadotani, H., Yamada, N., Sasakabe, T., Kawai, S., Naito, M., Tamura, T., and Wakai, K. (2024). The Inverse Association between the Frequency of Forest Walking (Shinrin-yoku) and the Prevalence of Insomnia Symptoms in the General Japanese Population: A Japan Multi-Institutional Collaborative Cohort Daiko Study. Int. J. Environ. Res. Public Health, 21.","DOI":"10.3390\/ijerph21030350"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1553716","DOI":"10.1155\/2022\/1553716","article-title":"Effect of Forest-Based Health and Wellness on Sleep Quality of Middle-Aged People","volume":"2022","author":"Quan","year":"2022","journal-title":"J. Sens."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.explore.2023.11.006","article-title":"Impact of sleeping in a forest on sleep quality and mental well-being","volume":"20","author":"Hassan","year":"2024","journal-title":"Explore"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1589\/jpts.31.408","article-title":"Effects of increased daily physical activity on mental health and depression biomarkers in postmenopausal women","volume":"31","author":"Takahashi","year":"2019","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1089\/ham.2010.1058","article-title":"Positive association between altitude and suicide in 2584 U.S. counties","volume":"12","author":"Barry","year":"2011","journal-title":"High Alt. Med. Biol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1080\/09540261.2019.1586324","article-title":"Altitude and risk of depression and anxiety: Findings from the intern health study","volume":"31","author":"Kious","year":"2019","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Wang, J., Zhou, Y., Liang, Y., and Liu, Z. (2019). A Large Sample Survey of Tibetan People on the Qinghai-Tibet Plateau: Current Situation of Depression and Risk Factors. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17010289"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1159\/000502891","article-title":"The Efficacy of Light Therapy in the Treatment of Seasonal Affective Disorder: A Meta-Analysis of Randomized Controlled Trials","volume":"89","author":"Pjrek","year":"2020","journal-title":"Psychother. Psychosom."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Brazien\u0117, A., Venclovien\u0117, J., Vai\u010diulis, V., Luk\u0161ien\u0117, D., Tamo\u0161i\u016bnas, A., Milvidait\u0117, I., Radi\u0161auskas, R., and Bobak, M. (2022). Relationship between Depressive Symptoms and Weather Conditions. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095069"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1177\/039463200902200410","article-title":"Effect of phytoncide from trees on human natural killer cell function","volume":"22","author":"Li","year":"2009","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Roviello, V., Scognamiglio, P.L., Caruso, U., Vicidomini, C., and Roviello, G.N. (2021). Evaluating In Silico the Potential Health and Environmental Benefits of Houseplant Volatile Organic Compounds for an Emerging \u2018Indoor Forest Bathing\u2019 Approach. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19010273"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"307","DOI":"10.5455\/medarh.2021.75.307-312","article-title":"Non-Pharmacological Measures in the Prevention and Treatment of COVID-19 Infection","volume":"75","author":"Zildzic","year":"2021","journal-title":"Med. Arch."},{"key":"ref_68","unstructured":"Li, Q. (2018). Shinrin-yoku: The Art and Science of Forest Bathing, Penguin Random House UK."},{"key":"ref_69","unstructured":"Li, Q. (2012). Chapter 3. Phytoncides in forest atmosphere. Forest Medicine, Nova Science Publishers, Inc.. Available online: https:\/\/novapublishers.com\/shop\/forest-medicine\/."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/4\/100\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:04:21Z","timestamp":1760029461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/4\/100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":69,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["diseases13040100"],"URL":"https:\/\/doi.org\/10.3390\/diseases13040100","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}