The effect of nature exposure on the mental health of patients: a systematic review

  • C. H. TrøstrupEmail author
  • A. B. Christiansen
  • K. S. Stølen
  • P. K. Nielsen
  • R. Stelter



The effect of nature-based interventions on self-reported mental well-being in patients with physical disease is gaining increasing attention. However, there is a lack of randomized controlled trials investigating this area. Due to the massive costs in health care systems, there is a need for new strategies to address these issues and an urgent need for attention to this field. Nature-based interventions are low cost, easy to implement, and should get attention within the health care field. Therefore, the objective was to find the impact of nature interventions on mental well-being in humans with a physical disease.


In four major databases (PubMed, Cinahl, PsycINFO, and Cochrane Library), a systematic review of quantitative studies of nature’s impact on self-reported mental health in patients with physical disease was performed. A total of 1909 articles were retrieved but only five met the inclusion criteria and were summarized.


All five studies were quantitative, with a control group and a nature-based intervention. A source of heterogeneity was identified: the patients in one of the five studies were psychosomatic. In the four studies with somatic patients, significant benefit of nature on self-reported mental health outcomes was found; the only study that failed to show a significant benefit was the one with psychosomatic patients.


A significant effect of nature on mental well-being of patients with somatic disease was found. The result in patients with psychosomatic disease is inconclusive, and more studies in this category are needed. Further research on the effect of nature on mental health is merited, with special attention to standardizing intervention type and dose as well as outcome measures within each medical discipline.


Systematic review Patients Nature Nature-based interventions Mental well-being 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. The study is a literature review.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • C. H. Trøstrup
    • 1
    • 2
    • 3
    Email author
  • A. B. Christiansen
    • 2
  • K. S. Stølen
    • 2
  • P. K. Nielsen
    • 2
  • R. Stelter
    • 1
  1. 1.Department of Nutrition, Exercise and Sports, Faculty of ScienceUniversity of CopenhagenCopenhagenDenmark
  2. 2.Department of Management, Organisation and Administration. R&D Health.University College CopenhagenCopenhagenDenmark
  3. 3.Department of Oncology and Palliation Nordsjaellands HospitalHillerødDenmark

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