{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:38:15Z","timestamp":1783953495535,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Studies in psychiatric populations have found a positive effect of Horticultural therapy (HCT) on reductions in stress levels. The main objective of the present pilot study was to evaluate the impact of the addition of HCT to conventional clinical treatment (Treatment as Usual, TaU) in a sample of six female adolescents with anorexia nervosa restricting type (AN-R), as compared to six AN-R patients, matched for sex and age, under TaU only. This is a prospective, non-profit, pilot study on patients with a previous diagnosis of AN-R and BMI &lt; 16, recruited in 2020 in clinical settings. At enrolment (T0) and after treatment completion (TF), psychiatric assessment was performed. At T0, all the patients underwent: baseline electrocardiogram acquisition with a wearable chest strap for recording heart rate and its variability; skin conductance registration and thermal mapping of the individual\u2019s face. An olfactory identification test was administered both to evaluate the olfactory sensoriality and to assess the induced stress. One-way analyses of variance (ANOVAs) were performed to analyze modifications in clinical and physiological variables, considering time (T0, TF) as a within-subjects factor and group (experimental vs. control) as between-subjects factors. When the ANOVA was significant, post hoc analysis was performed by Paired Sample T-tests. Only in the HCT group, stress response levels, as measured by the biological parameters, improved over time. The body uneasiness level and the affective problem measures displayed a significant improvement in the HCT subjects. HCT seems to have a positive influence on stress levels in AN-R.<\/jats:p>","DOI":"10.3390\/nu14245198","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T03:27:57Z","timestamp":1670383677000},"page":"5198","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Horticultural Therapy May Reduce Psychological and Physiological Stress in Adolescents with Anorexia Nervosa: A Pilot Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0784-302X","authenticated-orcid":false,"given":"Olivia","family":"Curzio","sequence":"first","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-0277","authenticated-orcid":false,"given":"Lucia","family":"Billeci","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Belmonti","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris Foundation, 56128 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2022-0804","authenticated-orcid":false,"given":"Sara","family":"Colantonio","sequence":"additional","affiliation":[{"name":"Institute of Information Science and Technologies \u201cAlessandro Faedo\u201d (ISTI), National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4401-3896","authenticated-orcid":false,"given":"Lorenzo","family":"Cotrozzi","sequence":"additional","affiliation":[{"name":"Department of Agriculture, Food and Environment, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-8987","authenticated-orcid":false,"given":"Carlotta Francesca","family":"De Pasquale","sequence":"additional","affiliation":[{"name":"IRCCS Stella Maris Foundation, 56128 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Aurora","family":"Morales","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8228-0258","authenticated-orcid":false,"given":"Cristina","family":"Nali","sequence":"additional","affiliation":[{"name":"Department of Agriculture, Food and Environment, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-8126","authenticated-orcid":false,"given":"Maria Antonietta","family":"Pascali","sequence":"additional","affiliation":[{"name":"Institute of Information Science and Technologies \u201cAlessandro Faedo\u201d (ISTI), National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7844-3253","authenticated-orcid":false,"given":"Francesca","family":"Venturi","sequence":"additional","affiliation":[{"name":"Department of Agriculture, Food and Environment, University of Pisa, Via del Borghetto 80, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8335-5541","authenticated-orcid":false,"given":"Alessandro","family":"Tonacci","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council of Italy, Via Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Zannoni","sequence":"additional","affiliation":[{"name":"Child and Adolescent Rehabilitation Clinic \u201cGli Orti di ADA\u201d, Via dei Giacinti, 4, 56128 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-1573","authenticated-orcid":false,"given":"Sandra","family":"Maestro","sequence":"additional","affiliation":[{"name":"Child and Adolescent Rehabilitation Clinic \u201cGli Orti di ADA\u201d, Via dei Giacinti, 4, 56128 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1001\/archgenpsychiatry.2011.74","article-title":"Mortality rates in patients with anorexia nervosa and other eating disorders. 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