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This study evaluated the efficacy of horticultural therapy (HT) in improving affective symptoms and functional outcomes in individuals with depressive disorders. A systematic search was conducted across the PubMed, EMBASE, Cochrane Library, CINAHL, CEPS, CNKI, and Wanfang databases. Randomized controlled trials (RCTs) implementing HT were included. Outcomes assessed included differences between HT and control groups in depression, anxiety, physical function, cognitive function, social function, and quality of life. A random-effects model was used to calculate Hedges’ g. Risk of bias was assessed using the Cochrane Risk of Bias tool, and the certainty of evidence was evaluated using the GRADE approach. Thirteen RCTs (n = 960) were included. HT significantly improved depression (g = 1.050; 95 % CI: 0.663–1.437), anxiety (g = 0.702; 95 % CI: 0.341–1.062), cognition (g = 0.816; 95 % CI: 0.302–1.331), social function (g = 0.806; 95 % CI: 0.295–1.317), and quality of life (g = 0.947; 95 % CI: 0.633–1.260). Only one study reported improvement in physical function. Subgroup analyses revealed greater effects among inpatients with more severe baseline symptoms who received combined indoor-outdoor HT in care-providing settings for more than eight weeks. However, the certainty of evidence across outcomes ranged from very low to low due to risks of bias, inconsistency, and imprecision. This review provides preliminary support for the efficacy of HT in depressive disorders. Given methodological limitations and potential biases, further well-designed trials with registration, blinded assessors, and long-term follow-up are warranted. •HT significantly improved depression, anxiety, cognition, social function, and quality of life in depressive disorders.•Strongest effects seen in inpatients receiving indoor-outdoor HT in care settings for over eight weeks.•Findings support HT as a feasible adjunct or alternative to depression treatments; further trials are needed.

(1) Objectives: Mindfulness-based interventions have been receiving more attention in research for children with attention deficit hyperactivity disorder (ADHD). This systematic review and meta-analysis was conducted to synthesize the findings of randomized controlled trials of mindfulness-based interventions for children with ADHD. (2) Methods: A systematic review and meta-analysis of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until August 2022. (3) Results: The systematic review included 12 studies that met the inclusion criteria, and the meta-analysis included 11 studies. The overall effect sizes were g = 0.77 for ADHD symptoms, g = 0.03 for externalizing behavior problem, g = 0.13 for internalizing behavior problem, g = 0.43 for mindfulness, and g = 0.40 for parental stress for children with ADHD. (4) Conclusion: The results of this systematic review highlight the possible benefits of mindfulness-based interventions for children with ADHD.

Deficits in cognition, physical, and social functions in adults with schizophrenia may become salient with aging. While animal-assisted therapy (AAT) can benefit physical function in older adults and improve symptoms of psychotic disorders, the effect of AAT on middle-aged patients with schizophrenia is unclear. The current randomized controlled trial aimed to explore the efficacy of AAT for middle-aged patients with schizophrenia. Forty participants were randomly assigned to either the AAT or control group. The AAT group participated in one-hour sessions with dog-assisted group activities once a week for 12 weeks. The controls participated in dose-matched, non-animal-related recreational activities. Both groups remained on their usual psychotropic medication during the trial. Evaluations included the Chair Stand Test (CST), Timed Up-and-Go (TUG) test, Montreal Cognitive Assessment (MoCA), 5-Meter walk test (5MWT), and Assessment of Communication and Interaction Skills (ACIS). The increases in CST repetitions and ACIS scores were larger in the AAT group than in the controls. The two groups did not differ significantly in MoCA scores, TUG performance, or the 5MWT. The AAT group showed a greater increase in lower extremity strength and social skills, but no improvement in cognitive function, agility, or mobility. Further research with more sensitive evaluations and longer follow-up is needed.

Background/Objectives: Positive symptoms, negative symptoms, and emotional disturbances are core features of schizophrenia. Although horticultural therapy (HT) has shown promise as an adjunctive treatment, evidence supporting its effectiveness remains limited. This systematic review and meta-analysis aimed to assess the impact of HT on total symptoms, positive symptoms, negative symptoms, and emotional disturbances in individuals with schizophrenia. Methods: We conducted a search for randomized controlled trials (RCTs) published up to March 2024 across multiple databases, including PubMed, Embase, Cochrane Library, CINAHL, CEPS, CNKI, Wanfang, and Yiigle. A random-effects model was employed to calculate the standardized mean difference (SMD). Results: A total of 35 studies enrolling 2899 participants were included. Our results indicated that, in the short term (≦3 months), HT has moderate to large effect sizes on total symptoms (SMD = 0.690, 95% CI 0.463 to 0.916), positive symptoms (SMD = 0.695, 95% CI 0.038 to 1.351), negative symptoms (SMD = 0.681, 95% CI 0.395 to 0.967), depression (SMD = 0.646, 95% CI 0.334 to 0.959), and anxiety (SMD = 0.627, 95% CI 0.364 to 0.890), with more pronounced benefits for anxiety symptoms in patients with a shorter duration of illness. In the long term (>3 months), HT shows large effect sizes for total symptoms (SMD = 1.393, 95% CI 0.858 to 1.928), negative symptoms (SMD = 1.389, 95% CI 0.935 to 1.842), anxiety (SMD = 1.541, 95% CI 1.042 to 2.040), and moderate to large effect sizes for positive symptoms (SMD = 0.667, 95% CI 0.077 to 1.258) and depression (SMD = 0.707, 95% CI 0.198 to 1.217). Additionally, longer weekly treatment durations are associated with better outcomes for total symptoms and negative symptoms. Schizophrenia patients with more severe initial symptoms may be potential responders to HT. Conclusions: These findings support the efficacy of HT in improving symptoms and emotional well-being in schizophrenia patients. Further trials with more rigorous designs are warranted to confirm these benefits.

Background: Cognitive and physical deficits are core features of schizophrenia. Although Baduanjin and brisk walking (BW) have shown promise as intervention strategies, comparative evidence with follow-up and considering maintenance is limited. Objective: This study compared the effects of Baduanjin, BW, and health education (HE) on cognitive and physical outcomes in schizophrenia and examined whether a maintenance program could sustain these effects. Methods: In this single-blind three-arm randomized controlled trial, 60 patients with schizophrenia were assigned to Baduanjin (n = 20), BW (n = 20), or HE (n = 20). Interventions were conducted three times weekly for 12 weeks, each lasting 60 min, followed by a four-week home-based maintenance program with brochures and short message reminders. Cognitive outcomes were assessed using the Brief Assessment of Cognition in Schizophrenia, and physical outcomes included the Six-Minute Walk Test (6MWT), 30-Second Chair Stand Test (30CST), Timed Up-and-Go (TUG), motor dual-task TUG (TUGmanual), and cognitive dual-task TUG (TUGcognitive). Results: Baduanjin produced larger improvements than HE in verbal memory, attention and processing speed, executive function, and global cognition. BW significantly enhanced the working memory and global cognition versus HE, with additional improvements in attention and processing speed at follow-up. Both Baduanjin and BW improved the walking distance and lower-limb strength compared with HE, while Baduanjin outperformed BW and HE in balance and dual-task outcomes. Conclusions: Baduanjin and BW improved cognitive and physical functions in individuals with schizophrenia. Maintenance programs with short message reminders may help sustain these benefits.

Schizophrenia is characterized by psychiatric symptoms and emotional issues. While pharmacological treatments have limitations, non-pharmacological interventions are essential. Art therapy has the potential to enhance emotional expression, communication, and health; however, the effectiveness of visual art therapy remains uncertain. This systematic review and meta-analysis synthesizes the findings of randomized controlled trials (RCTs) of visual art therapy on positive symptoms, negative symptoms, and emotions in patients with schizophrenia. This study reviews RCTs published prior to February, 2024. The PubMed, Embase, Cochrane Library, CEPS, CNKI, Wanfang, and Yiigle databases were searched, and three independent researchers screened the studies. In this meta-analysis, standardized mean difference (SMD) was employed as a measure to calculate effect sizes for continuous variables using a random effects model, while the meta-regression and subgroup analyses were performed with patient and intervention characteristics. A total of 31 studies revealed visual art therapy had a significant small-to-moderate effect on positive symptoms (SMD = 0.407, 95% CI 0.233 to 0.581), a moderate effect on negative symptoms (SMD = 0.697, 95% CI 0.514 to 0.880), a moderate effect on depression (SMD = 0.610, 95% CI 0.398 to 0.821), and a large effect on anxiety (SMD = 0.909, 95% CI 0.386 to 1.433). The subgroup analysis revealed painting and handcrafts had significant effects on positive symptoms, negative symptoms, and emotions. Combined Chinese calligraphy and painting had significant effects on positive symptoms, depression, and anxiety. Better improvement was noted among the Asian population, and a longer weekly treatment duration was associated with better improvement in positive symptoms. Female participants tended to have more improvements in negative symptoms and anxiety through visual art therapy. The results indicate that visual art therapy has positive effects on the psychiatric symptoms and emotions of individuals with schizophrenia. We recommend future research further investigate art therapy modalities and durations.

Aim: We identify the main forest vegetation types in Taiwan, provide their formal definitions and describe their species composition, habitat affinities and distribution. Location: Taiwan. Methods: A data set of 9822 vegetation plots with environmental characteristics recorded in the field or derived from digital maps in GIS was compiled from historical literature and an extensive field survey. Using expert knowledge, 6574 of these plots were used to build a classification into broad vegetation types. The units of the resulting classification were formally defined using a Cocktail determination key, which can be used for the automatic assignment of new vegetation plots to these vegetation types. Results: Twelve vegetation types of zonal forests and nine types of azonal forests were distinguished. Zonal types in the subtropical region, from high mountains to foothills, are Juniperus subalpine coniferous woodland, Abies–Tsuga upper-montane coniferous forest, Chamaecyparis montane mixed cloud forest, Fagus montane deciduous broad-leaved cloud forest, Quercus montane evergreen broad-leaved cloud forest, Machilus–Castanopsis sub-montane evergreen broad-leaved forest, Phoebe–Machilus sub-montane evergreen broad-leaved forest and Ficus–Machilus semi-evergreen foothill forest. Zonal types in the tropical region, from high mountains to foothills, are Pasania–Elaeocarpus montane evergreen broad-leaved cloud forest, Drypetes–Helicia sub-montane evergreen broad-leaved forest, Dysoxylum–Machilus foothill evergreen broad-leaved forest and Aglaia– Ficus foothill evergreen broad-leaved forest. Azonal types are Illicium–Cyclobalanopsis tropical winter monsoon forest, Pyrenaria–Machilus subtropical winter monsoon forest, Diospyros–Champereia tropical rock-outcrop forest, Zelkova–Quercus subtropical rock-outcrop forest, Pinus successional woodland, Alnus successional woodland, Trema–Mallotus successional woodland, Scaevola–Hibiscus seashore woodland and Kandelia mangrove. Conclusions: The diversity of forest vegetation in Taiwan is strongly structured by the temperature and moisture gradient. Along the temperature gradient, five altitudinal zones can be recognized. Azonal forest types develop at sites affected by the winter monsoon, on steep slopes, rocky soils, in seashore saline habitats and in places disturbed by fire, landslides and human activities. Zonal vegetation contains a higher ratio of endemic and Pacific species and occurs in wetter habitats, whereas azonal vegetation contains co-existing species from different regions and usually occurs in drier habitats.

1. A future warmer climate is generally predicted to threaten reptiles. But many high-altitude reptiles that rely on external heat to survive current cold climate may benefit from future warmth. This prediction can be tested by simulating activity time and energetics of reptiles with a biophysical model. 2. We modelled the potential response of a high-altitude snake, Trimeresurus gracilis, to a 3 °C increase in air temperature, using the biophysical/behavioural NicheMapper model. Using animal and environmental properties, we first analysed the effects of shade level (i.e. the reduction of solar radiation) on activity time and energetics of T. gracilis. We then computed activity time, energetics and potential habitats in its current range of Taroko National Park, Taiwan (> 1800 m in altitude), with a spatial climate, vegetation and topography data set. 3. In the current climate, increased shade levels were predicted to decrease activity time, maintenance energy requirements and discretionary energy (i.e. energy left after maintenance costs are met). In heavy shade (i.e. 81—100% reduction of solar radiation) at 3000 and 3500 m, T. gracilis was predicted to have impaired digestive capacity and hence to be unable to meet basic maintenance costs for survival. In a warmer climate, the predicted digestive capacity, energetics and activity time of T. gracilis increase. But in heavy shade at 3500 m, the digestive capacity was predicted to remain impaired for supporting basic energy requirements for survival. 4. In the current climate, the predicted suitable habitat area (i.e. where T. gracilis obtains positive discretionary energy) in coniferous and coniferous—broadleaf forests decreased with increasing elevation. At elevations higher than 3000 m, most suitable habitats were in open areas like grasslands where T. gracilis was also predicted to have more discretionary energy than in heavily forested habitats. Our field sightings agreed with model predictions. A warmer climate was generally predicted to increase the activity time, energetics and habitat area, given the current vegetation pattern. 5. Overall, we demonstrate that metabolism, digestive function and vegetative shade levels are critical elements affecting T. gracilis' energetics and habitats with climate change. Trimeresurus gracilis is likely to benefit energetically from future warmth.

Montane cloud forest is one of the most endangered ecosystems. However, there are few comprehensive studies on the distribution of subtropical montane cloud forest (SMCF). Chamaecyparis forest is one type of SMCF in Taiwan, distributed across the whole island. This study describes eleven types of this forest in Taiwan based on the Braun-Blanquet approach. Plots were selected from the National Vegetation Database of Taiwan. Two alliances were defined, both of which belong to the order Fagetalia hayatae . Topography and altitude explain the contrasting habitat requirements of these two alliances, whereas seasonality of moisture, soil properties and altitude explain differences in floristic composition at the association level. The alliance of Chamaecyparidion formosanae on slopes and ridges includes coniferous or mixed coniferous and evergreen broad-leaved forests; it is found at higher altitudes and is more influenced by the summer monsoon than the other alliance. Five associations are defined within this alliance. The alliance of Pasanio kawakamii - Machilion japonicae growing on slopes and in valleys contains evergreen broad-leaved forests or forests with a mixture of coniferous and evergreen broad-leaved species. Six associations can be determined under the alliance of Pasanio kawakamii - Machilion japonicae . Classification of each syntaxon was formalized using Cocktail Determination Key.

Ecosystem vulnerability to climate change remains elusive in the species-rich Taiwan-Japan archipelago. We predicted potential habitats (PHs) of ten dominant evergreen broad-leaved tree species by using the current and twenty potential climate change scenarios using generalised additive models. The presence/absence records of each species, extracted from vegetation database, were used as response variables. Four climatic and one spatial variables were used as explanatory variables. The results showed that the interaction terms of spatial variable, indicating historical range shifts or species interactions, restricted the distribution of all the target species as much as that by the each climatic variable. The PHs of all the target species were predicted to consistently increase, and in particular, to expand northward and upward to the cool temperate zone. However, the PHs were predicted to decrease within the range of 23.6–38.1 % in the Ryukyu Islands for Castanopsis sieboldii and Elaeocarpus japonica, respectively, and within the range of 32.4–42.3 % in Taiwan for Camellia japonica and Distylium racemosum, respectively. These findings suggest that the four species will be vulnerable at the southern range limits; however, the remaining six species will potentially increase within the PH areas in the future at all regions.