E3 PreliminaryPreliminaryPEM ?ObservationalPeer-reviewedMachine draft
The Psychological Benefits of Forest Bathing in Individuals with Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Pilot Study.
Serrat, Mayte, Royuela-Colomer, Estíbaliz, Alonso-Marsol, Sandra et al. · Healthcare (Basel, Switzerland) · 2025 · DOI
Quick Summary
This study looked at whether spending time walking quietly in a forest could help people with ME/CFS and fibromyalgia feel better. Forty-four participants took a 3-hour guided walk through a Mediterranean forest, and researchers measured their pain, fatigue, anxiety, and mood before and after. Most symptoms improved after the walk, especially anxiety and negative feelings, though pain levels didn't change significantly.
Why It Matters
This research offers preliminary support for an accessible, low-cost non-pharmacological intervention that may reduce anxiety and improve mood in ME/CFS patients. For a population with limited treatment options, evidence of psychological benefit from nature-based activities could inform complementary care strategies and quality-of-life interventions.
Observed Findings
- State anxiety, positive affect, and negative affect showed large-to-very-large improvements immediately after the 3-hour forest walk.
- Fatigue and state mindfulness showed small-to-moderate improvements.
- Tension, depression, anger, and mood vigor all improved significantly.
- Self-reported pain did not show statistically significant change.
Inferred Conclusions
- Forest bathing may provide short-term psychological benefits, particularly for anxiety and mood, in individuals with FM and CFS/ME.
- The intervention was feasible and safe to implement in a specialized guided format.
- Affective and anxiety-related outcomes appear more responsive to forest bathing than pain-related outcomes in this population.
Remaining Questions
- Do these benefits persist beyond the immediate post-activity period, and is there a dose-response relationship (e.g., do longer or repeated sessions produce greater/lasting effects)?
- What are the mechanisms driving improvements in anxiety and mood—is it the forest environment specifically, physical activity, social engagement, or a combination?
- How do outcomes compare to other low-intensity activities or control conditions (e.g., structured rest, seated nature viewing, or standard care)?
What This Study Does Not Prove
This study does not establish that forest bathing is effective for reducing pain or fatigue in ME/CFS, nor does it prove lasting benefits beyond the immediate post-activity period. Without a control group, it cannot definitively separate the effects of forest exposure from placebo effects, expectation, or the simple benefit of guided social activity. The results may not generalize to other climates, forest types, or populations.
Tags
Symptom:PainFatigue
Method Flag:PEM Not DefinedNo ControlsSmall SampleExploratory OnlyMixed Cohort