Effects of visual art therapy on depressive symptoms in adults: a systematic review and meta-analysis

Objective: To systematically evaluate the intervention effects of visual art therapy on depressive symptoms in adults, and to examine its impact on anxiety symptoms. Methods: A systematic search was conducted in databases including CNKI, WanFang Data, VIP, Chinese Biomedical Literature Database (CBM), PubMed, Web of Science, Cochrane Library, and Embase from inception to March 2026. Randomized controlled trials were included in which visual art therapy was used to intervene in depressive symptoms among adults (≥18 years).Meta-analysis was performed using Stata 18.0 software.The primary outcome was depressive symptoms, measured by scales such as the BDI, GDS, HADS-D, and SDS, and the secondary outcome was anxiety symptoms, measured by scales such as the BAI, HADS-A, and SAS. Fixed-effect or random-effect models were selected according to the level of heterogeneity, and subgroup analyses were conducted. Results: A total of 12 randomized controlled trials involving 741 adults were included, with 377 participants in the intervention group and 364 in the control group.The meta-analysis showed that visual art therapy effectively alleviated depressive symptoms (SMD = -0.81, 95% CI: -1.16 to -0.46, P < 0.00001) and anxiety symptoms (SMD = -0.69, 95% CI: -0.90 to -0.48, P < 0.00001) in adults.Subgroup analyses indicated that interventions with a duration of