園藝治療於慢性思覺失調症：一個先驅研究

Horticultural Therapy in Chronic Schizophrenia: A Pilot Study

背景：思覺失調症是一種慢性精神疾病，常見正性及負性症狀，而藥物治療對於負性症 狀療效有限。園藝治療可能是一種可替代的輔助療法。此外，腦源性神經營養因子被認為與 思覺失調症的致病機轉有關。因此，本研究希望了解園藝治療對於慢性思覺失調症的效果， 以及探討血清腦源性神經營養因子與慢性思覺失調症病人的臨床症狀的關係。方法：本研究 維持一年，原本邀請二十位穩定服藥的慢性思覺失調症病人參與三個月的室內園藝治療，受 試者年齡落在二十歲到六十歲之間。療程前後，對受試者施測正性與負性症狀量表、羅森堡 自尊量表，並檢驗周邊血腦源性神經營養因子。結果：共計十五位受試者完成療程。經過三 個月的室內園藝治療，評估病人的正性、負性及一般精神病理症狀均有顯著改善（p < 0.005 到 p < 0.001）。十項中七項的量表之自尊程度亦有顯著上升（p < 0.005 到 p < 0.001）。周 邊血腦源性神經營養因子從 6.6255 ng/ml 上升到 11.6641 ng/ml，亦達顯著的統計意義 (p < 0.001)。結論：室內園藝治療副作用低，可能為慢性思覺失調症經濟有效的輔助治療方式。 此外，腦源性神經營養因子濃度的改變可能也有涉入思覺失調症的病理機轉。但未來仍需更 大的樣本數來證明此結果。

Background: Schizophrenia is a chronic mental illness with positive and negative symptoms. Medications have limited effect in obtaining remission for symptoms, especially in treating negative symptoms in patients with chronic schizophrenia. Horticultural therapy (HT) is a possible alternative treatment of schizophrenia. In addition, brain-derived neurotrophic factor (BDNF) is considered to be related to the psychopathology of schizophrenia. Therefore, we intended to study the treatment effect of horticultural therapy, and to understand the relationships between serum BDNF levels and clinical symptoms in chronic schizophrenic patients. Methods: During a one-year period, 20 chronic schizophrenic patients with stable medication use, were recruited in a three-month in-door HT. Patients received assessments with Positive and Negative Syndrome Scale (PANSS) and Rosenberg Self-esteem Scale (RSE), as well as had their peripheral serum BDNF levels checked before and after their three-month HT. Results: Fifteen participants had fi nished the program fi nally. Positive and Negative Syndrome Scale (PANSS) and 7 out of 10 Rosenberg Self-esteem Scale (RSE) were signifi - cantly improved after being enrolled in the HT program (from p < 0.05 to p < 0.01). Mean serum peripheral BDNF levels were also signifi cantly increased from 6.6 ng/ml to 11.71 ng/ml before and after a three-month in-door HT (p < 0.001). Conclusion: In-door HT may be a cost-effective and adverse effect-free alternative therapy for chronic schizophrenic patients. In addition, serum BDNF might be involved in the psychopathology. But, it needs a large sample to prove those study results in the future.