The Effect of Nature-Based Adventure Interventions on Depression: A Systematic Review

We conducted a systematic review to synthesize evidence of the effect of nature-based adventure (NBA) interventions on depressive symptoms. Our search was conducted in April 2021 and utilized the following databases: MEDLINE (PubMed), PsycINFO, SPORTDiscus, CINAHL, Google Scholar, and Clinicaltrials.gov. Forty-two studies (n = 2,689 participants) with different designs, published between 1979 and 2021, were included. Collectively, results suggest highly variable effects of NBA interventions on depressive symptoms, ranging from reductions in mean depression scores of up to 64% to increases in means scores of up to 18%. Patient adherence to interventions was also variable, and serious adverse events (e.g., leg fractures) did occur. Despite variability across studies, research generally showed that mountain-based and surfing interventions, coupled with other forms of care, may substantially reduce adults’ depressive symptoms more than usual care alone or no intervention, highlighting the potential benefits of some NBA activities for individuals experiencing depressive symptoms.