Mood Emot 2019 Jul; 17(2): 63-69  
Effects of Outdoor Activities in Forests on Atopic Dermatitis
Woo Kyung Kim, MD, PhD1, Won Kim, MD, PhD2, Jong-Min Woo, MD, MPH, PhD3
Departments of 1Pediatrics, 2Psychiatry, Seoul Paik Hospital, Inje University College of Medicine, Seoul, 3Hanbyul Psychiatric Hospital, Gimpo, Korea
Correspondence to: Jong-Min Woo, MD, MPH, PhD
Hanbyul Psychiatric Hospital, 95 Gamam-ro, Gimpo 10099, Korea
TEL +82-31-986-9900 FAX +82-31-986-9901 E-mail jongmin.woo@gmail.com ORCID https://orcid.org/0000-0003-1314-126X
Received: February 19, 2019; Revised: March 18, 2019; Accepted: March 18, 2019; Published online: July 31, 2019.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The aim of this study was to determine the effects of out-door activities in the forest environment, the so-called “forest therapy program,” among children with atopic dermatitis (AD).
Methods: A total of 40 children with moderate-severity AD were enrolled in this study. All subjects were divided into either the “forest group” participating in the forest therapy program or the control group. The vitamin D level and quality of life (QOL) were measured at the initial visit and 8-week final visit.
Results: The SCORing Atopic Dermatitis (SCORAD) index was reduced significantly more in the forest group than in the control group (39.17±4.48 vs. 27.00±4.87); however, it did not reach statistical significance. The vitamin D (25(OH)-D3) level was increased significantly more in the forest group than in the control group (p>0.001). The mean QOL score was not significantly decreased in the forest group.
Conclusion: The forest therapy program was proven to be associated with the reduction of the SCORAD index and the increase of vitamin D level. However, QOL measures did not show statistically significant improvement. Thus, the forest therapy program may have a positive trend of biological and psychosocial effects in children with AD.
Keywords: Atopic dermatitis; Forests; Vitamin D; Quality of life


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