Association Between Green Space Exposure and Depressive Symptoms in Adolescents: A Systematic Review

Adolescent depression has become a growing global public health problem. Although existing research suggests that urban green spaces have a positive effect on mental health, most studies have been conducted with adults or older adults. As a vulnerable group at a critical developmental stage, adolescents may exhibit different psychological responses to green space exposure in their residential environments, necessitating in-depth exploration. Focusing on the relationship between green space exposure and depressive symptoms among adolescents aged 13-19 years, this review synthesizes cohort studies, cross-sectional surveys, and systematic reviews published between January 2019 and July 2025, analyzing the effects of variables including green space distribution, accessibility, and frequency of use. Findings suggest that greater access to green spaces in adolescents is generally associated with reduced depressive symptoms, an effect that may be realized through stress moderation and enhanced social support. However, existing studies differ in design, measurement tools, and control of confounders, limiting the generalizability of findings. Notably, the dose-response relationship between green space exposure and depressive symptoms remains largely unexplored. Future studies should standardize green space exposure assessments, explore dose-response relationships, and focus on cultural and socioeconomic factors to guide mental health interventions and urban greening planning.