Atténuer une schizophrénie par le jardin thérapeutique

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A meta-analysis evaluates the effectiveness of horticultural therapy and horticultural therapy for people with schizophrenia compared with standard care or other psychosocial interventions.

A Chinese meta-analysis of Liu and colleagues published in the Cochrane Collaboration Review in 2014 examining the effectiveness of horticulture for people with schizophrenia compared to treatment and psychosocial interventions classic. The existence of a single randomized controlled trial does not currently concluding on the efficacy and safety of the INM for people with schizophrenia.

The Study Rationale

Schizophrenia is a severe form of mental illness. It is characterized by psychotic symptoms such as delusions and hallucinations. It is also characterized by negative symptoms such as social withdrawal, loss of motivation and inability to experience pleasure. Patients may also have cognitive and behavioral disorders. These symptoms lead to significant social and occupational dysfunction. These people have a life expectancy significantly reduced compared to the general population, because of unnatural death (suicide and accident) and physiological disorders (heart disease, endocrine, respiratory and infectious diseases). Medicated treatments are the basic treatment of schizophrenia. However, in 5% to 15% of patients, symptoms persist and treatments often appear side effects.

The horticultural therapy, also called horticultural therapy, is defined by the American Horticultural Therapy Association  as non-pharmacological treatment that uses gardening activities to help participants improve their health and wellbeing.

The Question

An intervention in horticultural therapy she improves wellbeing, reduces the quality of life and anxiety and depression symptoms in people with schizophrenia?

The Protocol

Chinese meta-analysis type Cochrane decided on a single randomized controlled trial quality (Kam et al., 2010) testing the effectiveness of horticulture in people with schizophrenia or related disorders such as schizophreniform disorder, the schizoaffective disorder and delusional disorder. The effectiveness of this intervention is compared to a control group receiving conventional psychiatric care.

This study included 24 people with an average age of 44 years. The endpoints studied were well-being and quality of life (PWI-C). Mental and behavioral state was also studied with the scale Depression Anxiety Stress Scale (DASS21). The measurements were taken before the start of the intervention, in two weeks at the end of intervention.

The tested Non-Pharmacological Intervention (NPI)

The commitment of participants to collective horticultural therapy sessions were facilitated by a professional therapist or a qualified health. All participants had to maintain their usual care. Each session lasted one hour horticultural therapy for 10 consecutive days. A licensed therapist was responsible for the implementation of the horticulture program. Each session has a theme and a specific therapeutic goal:

– Session 1: garden tour

– Session 2: introduction to organic farming. Life balance and psychological stress management strategies.

– Session 3: courses on culture and plant growth, convenient watering and plant fertility. Awareness of the importance of self-protective factors in stress

– Session 4: practice and preparation weeding the vegetable plot. Sharing experiences related to coping strategies.

– Session 5: Teaching harvesting strategies, review and taste experience of fruit and vegetables. Sharing their interest and their success.

– Session 6: knowledge of plants, ability to identify and draw them. Sharing experiences related to their personal interests.

– Session 7: making a scarecrow. Sharing experiences related to handicrafts and strategies to cope with stress.

– Session 8: fill tea bags. Sharing strategies related to self-management of the supply.

– Session 9: teaching potting procedures. Sharing their hope and desire.

– Session 10: visit and introduction to the use of greenhouses. Share the experience of group activity.

Main Results

The meta-analysis does not prove conclusive in terms of the lack of randomized controlled trials. The only available study shows that the intervention in horticultural therapy combined with standard care improves anxiety and depression symptoms and short term stress of participants compared to current care alone.

What it means for Patients

The horticultural therapy combined with current treatments for schizophrenia could reduce anxiety and depressive symptoms and stress of people with schizophrenia. This conclusion should be confirmed by further studies.

What it means for Healthcare Professionals

The lack of current data do not support the conclusion about the benefits and drawbacks of horticultural therapy for people with schizophrenia.

What it means for Researchers

This meta-analysis could not identify a single randomized controlled trial on the effectiveness of horticultural therapy for patients with psychiatric disorders. Future clinical trials are needed to determine the effectiveness of horticultural therapy in the treatment of schizophrenia.

What it means for Policymakers

This meta-analysis does not provide sufficient evidence of the effectiveness of horticultural therapy in the treatment of schizophrenia. Studies are needed.

The reference

Liu Y, Bo L, Sampson S, Roberts S, Zhang G, Wu W (2014). Horticultural therapy for schizophrenia. Cochrane Database of Systematic Reviews, 5, CD009413.

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Same non-pharmacological intervention

To reference this Blog en Sante © article.

Ninot G (2016). Alleviate the symptoms of schizophrenia by the Therapeutic Garden. Blog en Sante, A84.

© Copyright 2016 Grégory Ninot. All rights reserved.