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Completed

NCT Number: NCT03996785

Effectiveness of Nature Walks in Depressed Adults

Over the past few years, a growing number of campaigns from around the world, including Canada, are highlighting the positive impact of spending time in nature on well-¬being. Indeed, mounting evidence suggests that spending time with nature is associated with a myriad of affective and cognitive benefits. Surprisingly few studies to date have tested the assumption that walking in nature versus in urban settings could alleviate stress and depressive symptoms in clinically depressed adults.

The main purpose of this study is to investigate the effectiveness of walking in nature versus in urban settings to improve depression related symptoms and reduce stress. The trial initially included 2 primary outcomes: patients stress levels (salivary cortisol) and depression-related symptoms (eg, affect, rumination, executive functioning).

However, due to hygienic concerns in light of the COVID-19 pandemic in 2020, the collection of saliva samples (and in turn, the measurement of stress levels via salivary cortisol) was removed from the study's procedure. The main outcome was changed to effects on positive and negative affect.

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Key information

Conditions

Experimental Depressive Disorder Depressive Disorder, Major Mental Disorders Mood Disorders

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Douglas Mental Health University Institute

Montreal, Quebec, H4H 1R3, Canada

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Men and women aged between 18 and 65 years, inclusively;
  • Ability to speak French or English;
  • Diagnosis major depressive disorder (DSM-IV);

Exclusion criteria

  • Acute psychotic symptoms;
  • Acute suicidal intent (within 48 hours);
  • Unable to walk for 60 min or serious medical reasons (e.g. major surgery)
  • Heart condition as per history or detected on electrocardiogram

Treatment and study plan

Walking in Urban setting

Behavioral

Walking for 60 minutes as described above

Walking in nature setting

Behavioral

Walking for 60 minutes as described above

Primary outcomes

  1. Change in affect from baseline up to 48 hours post-walk

    Time frame: Day 1 to Day 3

    Positive and Negative Affect Schedule (PANAS)

Secondary outcomes

  1. Change in Executive Functions

    Time frame: The Stroop test will be administered at 2 time points: 1) before the walk (between 9:45-10:30); 2) after the walk (between 11:30-11:50)

    The stroop color word test is a widely used task to assess selective attention and inhibitory control. In the first block of this task (A), color words (red, blue, yellow, green) printed in black ink are presented in random order and participants are asked to read out loud the words. In the second block (B), solid color patches in one of the same four colors are shown and participants name the colors. Finally, in the third block (C), color words are printed in an incongruous ink color and participants must name the ink color (e.g. GREEN [typed in red]; response = red). Participants are asked to complete each block as quickly and accurately as possible and the time to complete each trial is calculated and averaged for each block. An interference score is calculated as followed: C - [(A + B) /2].

  2. Change in suicidal Ideations

    Time frame: Day 1

    Severity of Suicidal Ideations The severity of current suicidal ideation will be assessed with three items derived from a prior study of momentary assessment of suicidal risk: "How intense is your desire to kill yourself right now"?; "How strong is your intention to kill yourself right now"?; "How strong is your ability to resist the urge to kill yourself right now"? Each item is scored on a scale from 0 (not strong [intense] at all) to 4 (very strong [intense]).

  3. Change in depressive symptoms

    Time frame: Day 1 to Day 2

    The Beck Depression Inventory (BDI-II) The BDI is a widely used 21-item depression inventory with good internal consistency (α = .93 in the current sample) and validity. Items are answered on a 4-point scale from 0 to 3.

  4. Change in rumination

    Time frame: Day 1

    The Rumination-Reflection Questionnaire (RRQ) The RRQ is a 24-item self-reported questionnaire assessing both self-rumination and self-reflection, 57 with 12 items corresponding to each subscale. Participants rate the degree to which they engage in self- rumination (e.g. "sometimes it is hard for me to shut off thoughts about myself") and self-reflective thoughts (e.g. "I love to meditate on the nature and meaning of things") on a Likert scale ranging from one (strongly disagree) to five (strongly agree)

  5. Change in irritability

    Time frame: Day 1 to Day 3

    The Brief Irritability Test (BITe): The BITe is a 5-item self-report measure of irritability that is suitable for use among men and women. Participants respond to statements using a 6-point Likert scale ranging from Never to Always. Items include the following five statements: "I have been grumpy"; "I have been feeling like I might snap"; "Other people have been getting on my nerves".

Sponsors and collaborators

Lead sponsor

McGill University

Other

Collaborators

  • Social Sciences and Humanities Research Council of Canada

Registry information

Official study title

Investigations of Immediate and Short-term Effects of Nature Walks on Stress and Depression-related Symptoms

Important dates

Study start
2019
Primary completion
2021
Study completion
2021
First posted
Jun 25, 2019
Registry last updated
Nov 12, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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