Empirically investigating how natural tourism activities alleviate symptoms in patients with Major Depressive Disorder through multidimensional pathways of physiological, psychological, and social functioning.
Voluntarily participate in the study and sign the informed consent form;
Age between 18 (inclusive) and 60 (exclusive) at the screening period;
Meet the DSM-5 diagnostic criteria for a Major Depressive Episode (MDE) at enrollment, based on medical records, clinical assessment, and the Mini-International Neuropsychiatric Interview (MINI version 7.0.2);
Hamilton Depression Rating Scale 17-item (HAMD-17) score ≥ 17 at both screening and baseline;
Current or past diagnosis of: schizophrenia, psychotic disorders (unless substance-induced or due to another medical condition), bipolar disorder, delusional disorder, paranoid personality disorder, schizoaffective disorder, borderline personality disorder, or other severe psychiatric comorbidities confirmed by medical history and structured clinical assessment using the Mini-International Neuropsychiatric Interview (MINI version 7.0.2);
Current or history of alcohol or substance abuse within the past year;
A score of ≥3 on item 3 (suicide) of the HAMD-17, suicide attempt within the past year, or clinically assessed significant suicide risk;
Depression secondary to other severe medical conditions (e.g., hypothyroidism, Parkinson's disease, etc.);
Shandong Provincial Hospital
Lead sponsor
Shandong University
Collaborator