Therapeutic Horticulture as an Adjunct To ECT For Inpatients: Study From Florida

 Out on PubMed, from researchers at the University of Florida in Gainesville, is this study:

Therapeutic Horticulture as a Therapeutic Intervention in Patients Receiving Electroconvulsive Therapy (ECT) Treatment for Major Depressive Disorder.

Korah T, Morrison D, Mason D, Diehl ER, Bussing R.Cureus. 2021 Aug 22;13(8):e17363. doi: 10.7759/cureus.17363. eCollection 2021 Aug. PMID: 34434684

The abstract is copied below:This study explored the effect of a structured therapeutic horticulture (TH) program on depression symptoms and quality of life indicators for individuals receiving inpatient electroconvulsive therapy (ECT) for major depressive disorders (MDD). Self-reported measures of depressive symptomatology (PHQ9, BDI-II) and quality of life (SF-36) were employed to compare intervention (n = 25) and control groups (n = 27), with the intervention group attending TH sessions for one-hour periods, twice per week, in addition to standard inpatient care associated with ECT received by both groups. All patients were assessed at admission, and after two weeks' time or prior to discharge, during which the intervention group participated in a minimum of four TH sessions. Sessions were led by a horticultural therapist in an accessible on-campus greenhouse. Both groups improved significantly between assessment times one and two on both measures of depression, with a statistically significant difference in change scores for the BDI-II only, favoring the control over the intervention group (16.5, s.d. 12.78 versus 9.6, s.d. 10.15; p = 0.36). Both groups improved significantly on four of eight SF-36 subscales during the same period. A statistically significant difference in change scores was found for the Role Limitations-Physical Health (RLPH) subscale, where the intervention group improved between assessment periods, whereas the control group worsened (16.0, s.d.48.8 versus -9.3, s.d. 33.4; p = .033). Although quantifying group changes or improvement for individuals receiving intensive treatment for major depressive disorders (ECT) by the addition of an adjunct therapy is difficult, this study provides a basic premise for the consideration of various therapeutic horticulture settings to achieve therapeutic benefits through TH.
Keywords: adjunct therapy; electroconvulsive therapy; major depressive disorder; quality of life; therapeutic horticulture.

The pdf is here.

And from the text:

Discussion 

This pilot study sought to explore whether patients suffering from MDD and treated with ECT may experience further improvements in depressive symptoms and quality of life through the addition of therapeutic horticulture. Results show that patients experienced significant improvement in their mood symptoms as assessed by PHQ-9 and BDI-II during their course of ECT treatment and that the addition of TH yielded no sizeable additional improvement on these outcome measures. A slightly larger improvement of BDI-II scores in the control group was observed but may be a function of higher BDI scores on admission in this group, with a larger opportunity for improvement, as both groups had comparable BDI-II scores at Time 2. These findings are consistent with other studies reporting significant improvements through inpatient ECT treatment for patients suffering from MDD and suggest that detecting additional improvements associated with receipt of less intensive treatment, such as TH, cannot be achieved through standard measures of depression. Nevertheless, further study of depression treatment enhancement, including with modalities such as TH, is called for because MDD has been recognized as the leading cause of disability and affected patients clearly show impairments in the quality of daily life; physical, psychological, social functioning; and overall wellbeing.

This is a nicely presented study about therapeutic horticulture (TH) as an adjunct to ECT, for improvement in quality of life (QOL) for inpatients on a psychiatric unit. The researchers bumped up against the ceiling effect of ECT being so effective. But they did see a positive difference in one subscale of the QOL assessment instrument in the TH intervention group, and certainly provided some stress reduction and a pleasant educational experience for these patients. The paper has a very positive and objective attitude towards ECT.

Thanks to these authors for contributing to the ECT QOL literature.