Empirically investigating how natural tourism activities alleviate symptoms in patients with Major Depressive Disorder through multidimensional pathways of physiological, psychological, and social functioning.
This study is an interventional randomized controlled trial aimed at evaluating whether natural tourism activities can improve the clinical symptoms of patients with Major Depressive Disorder and exploring the multidimensional mechanisms involving physiological, psychological, and social functioning. The target participant population is adult patients aged 18-60 who meet the DSM-5 diagnostic criteria for a major depressive episode. The core question to be addressed is whether the natural tourism intervention can significantly reduce the MADRS scores of patients with Major Depressive Disorder. Researchers will compare the intervention group (receiving structured tourism activities + conventional drug therapy) with the control group (receiving conventional drug therapy only) to verify the improvement effect of the tourism intervention on depressive symptoms and its potential mechanisms. Participants will complete the following tasks: * Participate in a one-day structured natural tourism activity; * Complete multiple scale assessments (including MADRS, HAMD-17, GAD-7, etc.) at baseline, on the day of intervention, and at one week and two weeks after the intervention; * Wear smart wearable devices to monitor physiological indicators such as sleep, heart rate and stress levels. From a theoretical perspective, this study promotes the transformation of tourism research from a "pleasure consumption" paradigm to a "neurobiological intervention" paradigm, aiming to propose an interdisciplinary mechanistic research pathway that reveals the positive therapeutic effects of tourism experiences on the pathology of Major Depressive Disorder. From a policy perspective, validating the clinical utility of tourism may reshape social prescription systems. While countries such as New Zealand and the United Kingdom have piloted "nature prescription" programs, there remains a lack of disease-specific protocols and efficacy evidence. Therefore, structured tourism interventions are expected to become a cost-effective complement to traditional treatments. As an interdisciplinary product integrating tourism and medicine, tourism therapy may emerge as a promising non-pharmacological prevention and treatment strategy. For tourism academia, it facilitates a theoretical transition from enhancing general well-being to clinical therapeutic applications; for mental health practice, it has the potential to break away from conventional treatments and establish itself as a novel therapeutic modality. Thus, in-depth exploration of the mechanisms through which tourism benefits patients with Major Depressive Disorder holds significant theoretical and practical implications. Employing a randomized controlled trial design, this study transcends the inherent limitations of cross-sectional research, aiming to provide innovative solutions to the global mental health crisis. The findings are expected to not only enrich guidelines for non-pharmacological interventions but also advance the transformation of the tourism industry toward a healing economy paradigm.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
86
Following the acquisition of participant consent and the signing of (electronic) informed consent forms, subjects were randomized into either an intervention group or a control group using a computer-generated randomization list. The intervention group received a tourism-based intervention, while the control group continued to receive usual care without any structured modifications to their daily living patterns or treatment plans. Both groups maintained a foundational treatment regimen of antidepressant medication.
Shandong Provincial Hospital Affiliated to Shandong First Medical University
Jinan, Shandong, China
NOT_YET_RECRUITINGShandong Provincial Hospital Affiliated to Shandong First Medical University
Jinan, Shandong, China
RECRUITINGChange in Depressive Symptoms
MADRS (Clinician-focused), Change from baseline in MADRS total score (range 0-60; higher = worse)
Time frame: Baseline, intervention day 1
Response from Depression
MADRS (Clinician-focused), ≥50% reduction from baseline in MADRS total score
Time frame: Baseline, 2-week follow-up
Remission from Depression
MADRS (Clinician-focused), MADRS total score ≤10
Time frame: Baseline, 2-week follow-up
Change in Depressive Symptoms
Change from baseline in HAM-D-17 (Clinician-focused), total score(higher = worse)
Time frame: Baseline, intervention day 1, 1-week follow-up, and 2-week follow-up
Change in Depressive Symptoms
Change from baseline in PHQ-9 (Patient-centered), total score(higher = worse)
Time frame: Baseline, intervention day 1, 1-week follow-up, and 2-week follow-up
Change in Depressive Symptoms
Change from baseline in QID-SR-16 (Patient-centered), total score(higher = worse)
Time frame: Baseline, intervention day 1, 1-week follow-up, and 2-week follow-up
Change in Anxiety Symptoms
GAD-7 (Patient-centered), Change from baseline in GAD-7 total score(higher = worse)
Time frame: Baseline, intervention day 1, 1-week follow-up, and 2-week follow-up
Clinical Improvement
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CGI-I response (defined as a CGI-I score of "very much improved" or "much improved").
Time frame: Baseline, 2-week follow-up