How Do People With Mental Illnesses Respond to Drawing as Art Therapy

Front end Psychol. 2021; 12: 686005.

Art Therapy: A Complementary Treatment for Mental Disorders

Jingxuan Hu

¹College of Creative Pattern, Shenzhen Engineering science University, Shenzhen, China

Jinhuan Zhang

²The Fourth Clinical Medical Higher of Guangzhou University of Chinese Medicine, Shenzhen, China

³Institute of Biomedical and Wellness Engineering, Shenzhen Institutes of Advanced Engineering science, Chinese Academy of Sciences, Shenzhen, Cathay

Liyu Hu

²The Quaternary Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Prc

Haibo Yu

ⁱⁱThe 4th Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, Red china

Jinping Xu

³Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Applied science, Chinese Academy of Sciences, Shenzhen, China

Received 2021 Mar 26; Accepted 2021 Jul 28.

Abstruse

Art therapy, as a not-pharmacological medical complementary and culling therapy, has been used as one of medical interventions with proficient clinical effects on mental disorders. Nonetheless, systematically reviewed in detail in clinical situations is lacking. Here, nosotros searched on PubMed for art therapy in an effort to explore its theoretical basis, clinical applications, and future perspectives to summary its global pictures. Since drawings and paintings take been historically recognized as a useful role of therapeutic processes in art therapy, we focused on studies of fine art therapy which mainly includes painting and drawing as media. As a result, a full of 413 literature were identified. After carefully reading full articles, nosotros found that art therapy has been gradually and successfully used for patients with mental disorders with positive outcomes, mainly reducing suffering from mental symptoms. These disorders mainly include depression disorders and anxiety, cognitive harm and dementias, Alzheimer's affliction, schizophrenia, and autism. These findings suggest that art therapy tin non only exist served equally an useful therapeutic method to assist patients to open up and share their feelings, views, and experiences, but besides as an auxiliary treatment for diagnosing diseases to assistance medical specialists obtain complementary data different from conventional tests. Nosotros humbly believe that art therapy has great potential in clinical applications on mental disorders to be further explored.

Keywords: painting, fine art therapy, mental disorders, clinical applications, medical interventions

Introduction

Mental disorders constitute a huge social and economic brunt for health intendance systems worldwide (Zschucke et al., 2013; Kenbubpha et al., 2018). In China, the lifetime prevalence of mental disorders was 24.xx%, and one-calendar month prevalence of mental disorders was fourteen.27% (Xu et al., 2017). The situation is more than severely in other countries, especially for developing ones. Given the large numbers of people in demand and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental wellness interventions to address this brunt. While pharmacological treatment is the beginning choice for mental disorders to alleviate the major symptoms, many antipsychotics contribute to poor quality of life and debilitating adverse effects. Therefore, clinicians have turned toward to complementary treatments, such every bit art therapy in addressing the health needs of patients more than half a century agone.

Art therapy, is defined past the British Clan of Art Therapists as: "a form of psychotherapy that uses art media as its chief way of expression and communication. Clients referred to art therapists are non required to have feel or skills in the arts. The art therapist'due south principal concern is not to make an esthetic or diagnostic assessment of the client's prototype. The overall goal of its practitioners is to enable clients to change and grow on a personal level through the use of artistic materials in a safe and convenient environs" (British Association of Art Therapists, 2015), whereas as: "an integrative mental wellness and homo services profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and homo experience within a psycho-therapeutic relationship" (American Art Therapy Association, 2018) according to the American Art Clan. It has gradually get a well-known form of spiritual back up and complementary therapy (Faller and Schmidt, 2004; Nainis et al., 2006). During the therapy, fine art therapists tin can utilize many different art materials as media (i.e., visual art, painting, drawing, music, trip the light fantastic toe, drama, and writing) (Deshmukh et al., 2018; Chiang et al., 2019). Among them, drawings and paintings have been historically recognized as the most useful function of therapeutic processes within psychiatric and psychological specialties (British Association of Art Therapists, 2015). Moreover, many other art forms gradually fall under the prevue of their own professions (e.thou., music therapy, dance/movement therapy, and drama therapy) (Deshmukh et al., 2018). Thus, we excluded these studies and only focused on studies of art therapy which mainly includes painting and drawing as media. Specifically, it focuses on capturing psychodynamic processes by ways of "inner pictures," which become visible past the creative procedure (Steinbauer et al., 1999). These pictures reflect the psychopathology of different psychiatric disorders and even their corresponding therapeutic process based on specific rules and benchmark (Steinbauer and Taucher, 2001). It has been gradually recognized and used as an alternative handling for therapeutic processes within psychiatric and psychological specialties, as well as medical and neurology-based scientific audiences (Burton, 2009).

The development of art therapy comes partly from the artistic expression of the belief in unspoken things, and partly from the clinical piece of work of fine art therapists in the medical setting with various groups of patients (Malchiodi, 2013). It is defined as the application of artistic expressions and images to individuals who are physically sick, undergoing invasive medical procedures, such as surgery or chemotherapy for clinical usage (Bar-Sela et al., 2007; Forzoni et al., 2010; Liebmann and Weston, 2015). The American Art Therapy Association describes its master functions equally improving cognitive and sensorimotor functions, fostering self-esteem and cocky-awareness, cultivating emotional resilience, promoting insight, enhancing social skills, reducing and resolving conflicts and distress, and promoting societal and ecological changes (American Art Therapy Association, 2018).

However, despite the above advantages, published systematically review on this topic is lacking. Therefore, this review aims to explore its clinical applications and futurity perspectives to summary its global pictures, so equally to provide more than clinical treatment options and research directions for therapists and researchers.

Publications of Art Therapy

The literatures about "art therapy" published from January 2006 to December 2020 were searched in the PubMed database. The following topics were used: Title/Abstract = "art therapy," Indexes Timespan = 2006–2020.

A total of 652 records were constitute. And then, nosotros manually screened out the literatures that contained the word "art" simply was not relevant with the subject of this study, such equally state of the art therapy, antiretroviral therapy (ART), and assisted reproductive technology (Art). Finally, 479 records about art therapy were identified. Since nosotros aimed to focus on art therapy included painting and drawing as major media, we screened out literatures deeper, and identified 413 (84%) literatures involved in painting and drawing (Figure one).

An external file that holds a picture, illustration, etc. Object name is fpsyg-12-686005-g001.jpg

Number of publications about art therapy.

As we can encounter, the number of literature about art therapy is increasing slowly in the last xv years, reaching a top in 2020. This indicates that more effort was fabricated on this topic in recent years (Figure i).

Overview of Fine art Therapy

As defined by the British Association of Art Therapists, fine art therapy is a grade of psychotherapy that uses art media as its principal mode of advice. Based on above literature, several highlights need to be summarized. (i) The principal media of art therapy include painting, drawing, music, drama, dance, drama, and writing (Chiang et al., 2019). (ii) Main contents of painting and drawing include blind drawing, spiral drawing, cartoon moods and self-portraits (Legrand et al., 2017; Abbing et al., 2018; Papangelo et al., 2020). (3) Fine art therapy is mainly used for cancer, low and anxiety, autism, dementia and cognitive impairment, equally these patients are reluctant to express themselves in words (Attard and Larkin, 2016; Deshmukh et al., 2018; Chiang et al., 2019). It plays an of import role in facilitating engagement when straight verbal interaction becomes difficult, and provides a safe and indirect way to connect oneself with others (Papangelo et al., 2020). Moreover, we institute that art therapy has been gradually and successfully used for patients with mental disorders with positive outcomes, mainly reducing suffering from mental symptoms. These findings suggest that art therapy tin not only exist served every bit an useful therapeutic method to assist patients to open up up and share their feelings, views, and experiences, but as well every bit an auxiliary treatment for diagnosing diseases to help medical specialists obtain complementary data different from conventional tests.

Art Therapy for Mental Disorders

Based on the 413 searched literatures, we further limited them to mental disorders using the post-obit cardinal words, respectively: Depression OR feet OR Cognitive impairment OR dementia OR Alzheimer's illness OR Autism OR Schizophrenia OR mental disorder. Every bit a result, a total of 23 studies (5%) (Tabular array 1) were included and classified afterward reading the abstruse and the full text carefully. These studies include 9 articles on depression and anxiety, 4 articles on cognitive damage and dementia, 3 manufactures on Alzheimer's disease, three articles on autism, and 4 articles on schizophrenia. In addition to the English language literature, in fact, some Chinese literatures also described the application of art therapy in mental diseases, which were not listed simply referred to in the post-obit specific literatures.

TABLE 1

Studies of art therapy in mental diseases.

Blazon of diseases/author and year	Country	Number (painting)	Treatment	Subjects	Master results
Depression and feet
Bar-Sela et al., 2007	Israel	19/41	once-weekly, 4w/2w	Cancer patients with depression and anxiety	In the intervention group, the median Hospital Feet and Depression Scale score for depression was 9 at the beginning and 7 after the fourth date.
Gussak, 2007	Unite States American	48	4-calendar week period, 2 group sessions per week	Low	The results reflected a meaning subtract in depressive symptoms in those inmates who participated in the program.
Geue et al., 2013	Germany	54	22 sessions	Cancer patients with psychological distress	Anxiety scores decreased in a pre–mail service comparison.
Crone et al., 2013	United kingdom of great britain and northern ireland	202	10-week intervention	Patients with anxiety, depression, or stress	There was a meaning improvement in well-existence.
Montag et al., 2014	Federal republic of germany	58	12 twice-weekly sessions	Acute psychotic episodes with depression	Patients in the Fine art grouping showed significant improvement in levels of emotional awareness.
Armstrong and Howatson, 2015	United kingdom	6 mothers/eight infants	12 consecutive weeks	Postpartum depression	The responses of the questionnaires were more positive after the intervention, and eight of the 10 mothers showed an improvement in postpartum depression and in the relationship with their children.
Lefèvre et al., 2016	France	28	63 art therapy sessions, i h/session	Cancer patients with low and anxiety	There was a meaning reduction in all of the symptoms: pain, feet, evil, fatigue, sadness, and depression.
Ciasca et al., 2018	Brazil	31/25	20 weekly art therapy sessions (90 min/session)	Depression	Fine art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms.
Forouzandeh et al., 2020	Iran	55	NA	Feet	Nurses should collaborate with medical teams to routinely employ not-pharmacological methods such as the painting and the interactive games to alleviate preoperative anxiety in children.
Cognitive impairment, and dementia
Rusted et al., 2016	United Kingdom	45	1 h each calendar week for 40 successive weeks	Dementia	Art therapy is benign and advisable interventions for older people with dementia.
State highway, 2013	Unite States American	91	10-calendar week art therapy	Cognitive impairment	Art therapy handling was associated with significantly improved cerebral performance.
Heymann et al., 2018	Germany	32	analysis of tree drawings on a digitizing tablet	Mild cognitive harm (MCI)	MCI group shows a higher recognition rate.
Yu et al., 2021	Singapore	22	weekly 45-min sessions were carried out across three months.	MCI	Significant gains in firsthand memory and working memory span were observed.
Alzheimer's illness
Witkoski and Chaves, 2007	Brazil	11	31 months	Alzheimer's disease	The selection of drawing or modeling showed significant association with severity of cerebral deficit.
Mimica and Kaliniæ, 2011	Croatia	1 example report	not available	Alzheimer'southward affliction	The art therapy was shown to be an fantabulous add-on not-pharmacological intervention, beneficial for reducing stress-related behaviors.
Hattori et al., 2011	Nippon	39	once weekly for 12 weeks	Alzheimer'south disease	Significant improvement in the quality of life was observed in the art therapy
Autism
Low et al., 2009	New Zealand	27	four 0.5 to 1 h sessions that were approximately 1 calendar week apart	Autism	There is an of import relationship between generativity and imagination.
Ten and Muller, 2018	Canada	22	i.v-h session	Autism	In that location are changes in the blazon of cognitive processes involved in imagination and children with autism employ a unique cognitive strategy in imaginative drawing.
Jalambadani, 2020	Iran	48	12 sessions	Autism	Autistic children showed more adaptive behaviors and emotions.
Schizophrenia
Richardson et al., 2009	United Kingdom	43	12 weekly sessions of one and a half hours	Schizophrenia	Art therapy produced a statistically significant positive effect on negative symptoms.
Teglbjaerg, 2011	Kingdom of denmark	v	2 h a calendar week	Schizophrenia	The positive effect of art therapy is mainly due to a strengthening of the Schizophrenia' minimal sense of self.
Mannheim et al., 2013	Serbian	2	once a week, ii months	Schizophrenia	The patient'south drawings show clinical comeback from the reduction of depressive themes and an increase in the frequency of human figure drawings and self-conviction.
Tong et al., 2020	China	104	ninety min for a total of 30 times in 15 weeks	Schizophrenia	Grouping fine art therapy can better self-efficacy and social part, reducing social and life office bug, and promote the recovery of individuals diagnosed with schizophrenia.

Depression Disorders and Anxiety

Depression and anxiety disorders are highly prevalent, affecting individuals, their families and the individual's part in society (Birgitta et al., 2018). Low is a disabling and plush status associated with a significant reduction in quality of life, medical comorbidities and bloodshed (Demyttenaere et al., 2004; Whiteford et al., 2013; Cuijpers et al., 2014). Anxiety is associated with lower quality of life and negative effects on psychosocial operation (Cramer et al., 2005). Medication is the about commonly used effective way to relieve symptoms of depression and anxiety. However, nonadherence are crucial shortcomings in using antidepressant to treat depression and anxiety (van Geffen et al., 2007; Nielsen et al., 2019).

In recent years, many studies have shown that art therapy plays a significant role in alleviating depression symptoms and anxiety. Gussak (2007) performed an observational survey almost populations in prison house of northern Florida and identified that art therapy significantly reduces depressive symptoms. Similarly, a randomized, controlled, and single-blind study about art therapy for depression with the elderly showed that painting as an adjuvant handling for depression can reduce depressive and feet symptoms (Ciasca et al., 2018). In addition, art therapy is likewise widely used among students, and several studies (Runde, 2008; Zhenhai and Yunhua, 2011) accept shown that art therapy also significantly reduces depressive symptoms in students. For case, Wang et al. (2011) conducted group painting therapy on 30 patients with depression for iii months, and found that painting therapy could promote their social role recovery, improve their social adjustability and quality of life. Another randomized clinical trial also showed that information technology could decrease mean feet scores in the 3–12 year painting group (Forouzandeh et al., 2020).

Studies have shown that distress, including feet and depression, is related to poorer health-related quality of life and satisfaction to medical services (Hamer et al., 2009). Painting tin be employed to express patients' anxiety and fright, vent negative emotions past applying projection, thereby significantly meliorate the mood and reduce symptoms of depression and feet of cancer patients. A number of studies (Bar-Sela et al., 2007; Thyme et al., 2009; Lin et al., 2012; Abdulah and Abdulla, 2018) showed that art therapy for cancer patients could enhance the vitality of patients and participation in social activities, significantly reduce depression, anxiety, and reduce stressful feelings. Importantly, even in the follow-upward menses, art therapy still has a lasting event on cancer patients (Thyme et al., 2009). Interestingly, art therapy based on famous painting appreciation could also significantly reduce feet and depression associated with cancer (Lee et al., 2017). Among cancer patients treated in outpatient health care, art therapy also plays an important function in alleviating their physical symptoms and mental health (Götze et al., 2009). Therefore, fine art therapy equally an auxiliary treatment of cancer is of bully value in improving quality of life.

Overall, art painting therapy permits patients to express themselves in a manner acceptable to the inside and outside civilisation, thereby diminishing depressed and anxiety symptoms.

Cerebral Impairment, and Dementia

Dementia, a progressive clinical syndrome, is characterized past widespread cognitive harm in memory, thinking, behavior, emotion and performance, leading to worse daily living (Deshmukh et al., 2018). According to the Alzheimer's Disease International 2015, there is 46.8 million people suffered from dementia, and numbers almost doubling every xx years, rising to 131.five 1000000 by 2050. Although fine art therapy has been used as an alternative treatment for the dementia for long fourth dimension, the positive effects of painting therapy on cognitive function remain largely unknown. One intervention assigned older adults patients with dementia to a group-based art therapy (including painting) observed significant improvements in the clock cartoon test (Motorway, 2013), whereas two other randomized controlled trials (Hattori et al., 2011; Rusted et al., 2016) on patients with dementia have failed to obtain significant cognitive comeback in the painting group. Moreover, a cochrane systematic review (Deshmukh et al., 2018) included ii clinical studies of art therapy for dementia revealed that there is no sufficient prove almost the efficacy of art therapy for dementia. This may exist because patients with severely cognitive impairment, who was unable to accurately remember or appraise their own behavior or mental country, might lose the ability to savour the benefits of art therapy.

In summary, we should intervene earlier in patients with mild cognitive damage, an intermediate stage between normal crumbling and dementia, in society to foreclose further transformation into dementia. To engagement, balmy cognitive harm is drawing much attention to the importance of painting intervening at this phase in order to alter the course of subsequent cognitive refuse as shortly equally possible (Petersen et al., 2014). Recently, a randomized controlled trial (Yu et al., 2021) showed pregnant relationship between improvement immediate retentivity/working retentivity span and increased cortical thickness in correct middle frontal gyrus in the painting art group. With the long-term cognitive stimulation and appointment from multiple sessions of painting therapy, information technology is likely that painting therapy could lead to enhanced cognitive performance for these patients.

Alzheimer's Disease

Alzheimer's disease (AD) is a sub-blazon of dementia, which is usually associated with chronic pain. Previous studies suggested that art therapy could be used as a complementary treatment to relief pain for these patients since medication might induce severely side effects. In a multicenter randomized controlled trial, 28 mild Advertizing patients showed meaning hurting reduction, reduced anxiety, improved quality of life, improved digit bridge, and inhibitory processes, also as reduced low symptoms afterward 12-week painting (Pongan et al., 2017; Alvarenga et al., 2018). Further study as well suggested that individual therapy rather than grouping therapy could exist more than optimal since neuroticism tin decrease efficacy of painting intervention on hurting in patients with balmy AD. In addition to release chronic hurting, fine art therapy has been reported to bear witness positive furnishings on cognitive and psychological symptoms in patients with balmy AD. For instance, a controlled report revealed pregnant comeback in the apathy calibration and quality of life later on 12 weeks of painting treatment mainly including color abstruse patterns with pastel crayons or water-based pigment (Hattori et al., 2011). Another written report also revealed that Advertizement patients showed improvement in facial expression, discourse content and mood later 3-weeks painting intervention (Narme et al., 2012).

Schizophrenia

Schizophrenia is a complex functional psychotic mental illness that affects about 1% of the population at some indicate in their life (Kolliakou et al., 2011). Not just do sufferers experience "positive" symptoms such equally hallucinations, delusions, only too experience negative symptoms such every bit varying degrees of anhedonia and asociality, impaired working memory and attending, poverty of speech, and lack of motivation (Andreasen and Olsen, 1982). Many patients with schizophrenia remain symptomatic despite pharmacotherapy, and even attempts to suicide with a rate of 10 to 50% (De Sousa et al., 2020). For these patients, art therapy is highly recommended to procedure emotional, cognitive and psychotic experiences to release symptoms. Indeed, many forms of art therapy have been successfully used in schizophrenia, whether and how painting may interfere with psychopathology to release symptoms remains largely unknown.

A contempo review including 20 studies overall was performed to summary findings, yet, ended that information technology is not clear whether fine art therapy leads to clinical improvement in schizophrenia with low (Ruiz et al., 2017). Anyway, many randomized clinical trials reported positive outcomes. For example, Richardson et al. (2007) conducted painting therapy for six months in patients with chronic schizophrenia and found that fine art therapy had a positive outcome on negative symptoms. Teglbjaerg (2011) examined experience of each patient using interviews and written evaluations before and after painting therapy and at a one-year follow-up and plant that group painting therapy in patients with schizophrenia could not only reduce psychotic symptoms, only also boost self-esteem and better social function.

What's more, the characteristics of the painting can also be used to judge the health status in patients with schizophrenia. For example, Hongxia et al. (2013) explored the correlation between psychological health condition and characteristics of House-Tree-Person tests for patients with schizophrenia, and showed that the particular characteristic of the test results tin exist used to judge the patient's feet, low, and obsessive-compulsive symptoms.

Most importantly, several other studies showed that drug plus painting therapy significantly enhanced patient compliance and self-cognition than drug therapy alone in patients with schizophrenia (Hongyan and JinJie, 2010; Min, 2010).

Autism

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental syndrome with no unified pathological or neurobiological etiology, which is characterized by difficulties in social interaction, communication problems, and a tendency to engage in repetitive behaviors (Geschwind and Levitt, 2007).

Art therapy is a course of expression that opens the door to advice without verbal interaction. It provides therapists with the opportunity to interact one-on-one with individuals with autism, and brand wide connections in a more than comfortable and effective way (Babaei et al., 2020). Emery (2004) did a case study about a 6-year-sometime boy diagnosed with autism and institute that art therapy is of neat value to the development, growth and communication skills of the boy. Recently, one written report (Jalambadani, 2020) using 40 children with ASD participating in painting therapy showed that painting therapy had a significant comeback in the social interactions, adaptive behaviors and emotions. Therefore, encouraging children with ASD to express their experience by using nonverbal expressions is crucial to their development. Evans and Dubowski (2001) believed that creating images on paper could help children limited their internal images, thereby raise their imagination and abstract thinking. Painting tin can likewise help autistic children express and vent negative emotions and thereby bring positive emotional experience and promote their self-consciousness (Martin, 2009). According to two studies (Wen and Zhaoming, 2009; Jianhua and Xiaolu, 2013) in Red china, Art therapy could also improve the language and communication skills, cognitive and behavioral performance of children with ASD.

Moreover, art therapy could be used to investigate the relationship betwixt cerebral processes and imagination in children with ASD. 1 study (Wen and Zhaoming, 2009; Jianhua and Xiaolu, 2013) suggested that children with ASD apply a unique cognitive strategy in imaginative cartoon. Another study (Low et al., 2009) examined the cognitive underpinnings of spontaneous imagination in children with ASD and showed that ASD group lacks imagination, generative power, planning power and good consistency in their drawings. In addition, several studies (Leevers and Harris, 1998; Craig and Businesswoman-Cohen, 1999; Craig et al., 2001) have been performed to investigate imagination and creativity of autism via drawing tasks, and showed impairments of autism in imagination and creativity via drawing tasks.

In a discussion, art therapy plays a meaning role in children with ASD, not only as a method of handling, but as well in agreement and investigating patients' problems.

Other Applications

In add-on to the above mentioned diseases, art therapy has as well been adopted in other applications. Dysarthia is a common sequela of cerebral palsy (CP), which straight affects children's language intelligibility and psycho-social adjustment. Speech therapy does not e'er assist CP children to speak more intelligibly. Interestingly, the art therapy can significantly ameliorate the linguistic communication intelligibility and their social skills for children with CP (Wilk et al., 2010).

In brief, these studies advise that art therapy is meaningful and accepted by both patients and therapists. Most oft, art therapy could strengthen patient'due south emotional expression, self-esteem, and self-awareness. However, our findings are based on relatively small samples and few practiced-quality qualitative studies, and require cautious interpretation.

The Awarding Prospects of Art Therapy

With the evolution of modern medical engineering, life expectancy is also increasing. At the same time, information technology also brings some side effects and psychological problems during the treatment process, especially for patients with mental illness. Therefore, at that place is an increasing demand for finding appropriate complementary therapies to ameliorate life quality of patients and psychological health. Fine art therapy is primarily offered as individual art therapy, in this review, we found that art therapy was near commonly used for depression and anxiety.

Based on the higher up findings, fine art therapy, every bit a non-verbal psychotherapy method, not only serves as an auxiliary tool for diagnosing diseases, which helps medical specialists obtain much information that is difficult to gain from conventional tests, judge the severity and progression of diseases, and sympathize patients' psychological state from painting characteristics, but besides is an useful therapeutic method, which helps patients open up up and share their feelings, views, and experiences. Additionally, the implementation of art therapy is not limited by age, language, diseases or surroundings, and is like shooting fish in a barrel to be accustomed past patients.

Art therapy in hospitals and clinical settings could be very helpful to assist treatment and therapy, and to enhance communications between patients and on-site medical staffs in a non-verbal manner. Moreover, fine art therapy could be more constructive when combined with other forms of therapy such as music, dance and other sensory stimuli.

The medical mechanism underlying fine art therapy using painting as the medium for intervention remains largely unclear in the literature (Salmon, 1993; Broadbent et al., 2004; Guillemin, 2004), and the show for effectiveness is insufficient (Mirabella, 2015). Although a number of studies have shown that art therapy could meliorate the quality of life and mental wellness of patients, standard and rigorous clinical trials with big samples are still lacking. Moreover, the long-term upshot is even so to be assessed due to the lack of follow-upwardly assessment of art therapy.

In some cases, art therapy using painting every bit the medium may be difficult to exist implemented in hospitals, due to medical and health regulations (may be partly due to potential of messes, lack of sink and cleaning space for proper disposal of paints, storage of paints, and toxins of allergens in the paint), bereft space for the artwork to dry without getting in the way or getting damaged, and negative medical settings and family environments. Nevertheless, these difficulties can be overcome due to great benefits of the art therapy. We thus humbly believe that fine art therapy has great potential for mental disorders.

In the time to come, art therapy may be more thoroughly investigated in the following directions. Kickoff, more than high-quality clinical trials should be carried out to gain more reliable and rigorous evidence. 2d, the evaluation methods for the effectiveness of art therapy need to be as various as possible. Information technology is necessary for the investigation to include not only subjective scale evaluations, but also objective ways such equally brain imaging and hematological examinations to be more than convincing. Tertiary, it will exist helpful to specify the details of the art therapy and patients for objective comparisons, including types of diseases, painting methods, required qualifications of the therapist to perform the art therapy, and the theoretical basis and mechanism of the therapy. This practice should exist continuously promoted in both hospitals and communities. Fourth, guidelines about art therapy should exist gradually formed on the basis of accumulated evidence. Finally, machinery of art therapy should be farther investigated in a diversity of ways, such as at the neurological, cellular, and molecular levels.

Author Contributions

JH designed the whole study, analyzed the data, and wrote the manuscript. JZ searched for selected the studies. LH participated in the interpretation of information. HY and JX offered expert suggestions. All authors read and canonical the concluding manuscript.

Conflict of Involvement

The authors declare that the inquiry was conducted in the absence of any commercial or fiscal relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do non necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any production that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Footnotes

Funding. This study was financially supported by the National Key R&D Program of China (2019YFC1712200), International standards enquiry on clinical enquiry and service of Acupuncture-Moxibustion (2019YFC1712205), the National Natural Science Foundation of China (62006220), and Shenzhen Science and Technology Research Plan (No. JCYJ20200109114816594).

References

Abbing A., Ponstein A., van Hooren S., de Sonneville L., Swaab H., Baars E. (2018). The effectiveness of art therapy for anxiety in adults: a systematic review of randomised and non-randomised controlled trials. PLoS One 13:e208716. x.1371/journal.pone.0208716 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Abdulah D. 1000., Abdulla B. (2018). Effectiveness of group fine art therapy on quality of life in paediatric patients with cancer: a randomized controlled trial. Complement. Ther. Med. 41 180–185.10.1016/j.ctim.2018.09.020 [PubMed] [CrossRef] [Google Scholar]
Alvarenga W. A., Leite A., Oliveira K. Due south., Nascimento L. C., Silva-Rodrigues F. M., Nunes M. D. R., et al. (2018). The effect of music on the spirituality of patients: a systematic review. J. Holist. Nurs. 36 192–204. 10.1177/0898010117710855 [PubMed] [CrossRef] [Google Scholar]
American Art Therapy Association (2018). Definition of Art. Bachelor online at: https://arttherapy.org/about-fine art-therapy/ [Google Scholar]
Andreasen North. C., Olsen S. (1982). Negative v positive schizophrenia. Definition and validation. Arch. Gen. Psychiatry 39 789–794. x.1001/archpsyc.1982.04290070025006 [PubMed] [CrossRef] [Google Scholar]
Armstrong V. Chiliad., Howatson R. (2015). Parent-infant art psychotherapy: a artistic dyadic approach to early intervention. Infant Ment. Wellness J. 36 213–222. ten.1002/imhj.21504 [PubMed] [CrossRef] [Google Scholar]
Attard A., Larkin M. (2016). Fine art therapy for people with psychosis: a narrative review of the literature. Lancet Psychiatry 3 1067–1078. 10.1016/s2215-0366(sixteen)30146-8 [PubMed] [CrossRef] [Google Scholar]
Babaei S., Fatahi B. Southward., Fakhri Yard., Shahsavari Southward., Parviz A., Karbasfrushan A., et al. (2020). Painting therapy versus anxiolytic premedication to reduce preoperative anxiety levels in children undergoing tonsillectomy: a randomized controlled trial. Indian J. Pediatr. 88 190–191. 10.1007/s12098-020-03430-ix [PubMed] [CrossRef] [Google Scholar]
Bar-Sela G., Atid 50., Danos South., Gabay North., Epelbaum R. (2007). Art therapy improved low and influenced fatigue levels in cancer patients on chemotherapy. Psychooncology 16 980–984. ten.1002/pon.1175 [PubMed] [CrossRef] [Google Scholar]
Birgitta G. A., Wagman P., Hedin Grand., Håkansson C. (2018). Treatment of low and/or feet–outcomes of a randomised controlled trial of the tree theme method^® versus regular occupational therapy. BMC Psychol. 6:25. x.1186/s40359-018-0237-0 [PMC free commodity] [PubMed] [CrossRef] [Google Scholar]
British Clan of Art Therapists (2015). What is Art Therapy? Bachelor online at: https://www.baat.org/About-Art-Therapy [Google Scholar]
Broadbent East., Petrie 1000. J., Ellis C. J., Ying J., Take a chance Grand. (2004). A picture of health–myocardial infarction patients' drawings of their hearts and subsequent disability: a longitudinal study. J. Psychosom. Res. 57 583–587. [PubMed] [Google Scholar]
Burton A. (2009). Bringing arts-based therapies in from the scientific common cold. Lancet Neurol. 8 784–785. 10.1016/s1474-4422(09)70216-nine [PubMed] [CrossRef] [Google Scholar]
Chiang M., Reid-Varley Westward. B., Fan X. (2019). Creative art therapy for mental illness. Psychiatry Res. 275 129–136. 10.1016/j.psychres.2019.03.025 [PubMed] [CrossRef] [Google Scholar]
Ciasca East. C., Ferreira R. C., Santana C.L. A., Forlenza O. V., Dos Santos M. D., Brum P. Southward., et al. (2018). Art therapy as an adjuvant treatment for low in elderly women: a randomized controlled trial. Braz. J. Psychiatry 40 256–263. 10.1590/1516-4446-2017-2250 [PMC gratis article] [PubMed] [CrossRef] [Google Scholar]
Craig J., Baron-Cohen S. (1999). Creativity and imagination in autism and Asperger syndrome. J. Autism Dev. Disord. 29 319–326. [PubMed] [Google Scholar]
Craig J., Baron-Cohen S., Scott F. (2001). Drawing ability in autism: a window into the imagination. Isr. J. Psychiatry Relat. Sci. 38 242–253. [PubMed] [Google Scholar]
Cramer Five., Torgersen Due south., Kringlen E. (2005). Quality of life and anxiety disorders: a population report. J. Nerv. Ment. Dis. 193 196–202. 10.1097/01.nmd.0000154836.22687.13 [PubMed] [CrossRef] [Google Scholar]
Crone D. M., O'Connell E. Due east., Tyson P. J., Clark-Rock F., Opher S., James D. 5. (2013). 'Art Lift' intervention to meliorate mental well-being: an observational study from U.K. general do. Int. J. Ment. Wellness Nurs. 22 279–286. 10.1111/j.1447-0349.2012.00862.x [PubMed] [CrossRef] [Google Scholar]
Cuijpers P., Vogelzangs N., Twisk J., Kleiboer A., Li J., Penninx B. W. (2014). Comprehensive meta-assay of excess bloodshed in low in the full general community versus patients with specific illnesses. Am. J. Psychiatry 171 453–462. 10.1176/appi.ajp.2013.13030325 [PubMed] [CrossRef] [Google Scholar]
De Sousa A., Shah B., Shrivastava A. (2020). Suicide and Schizophrenia: an interplay of factors. Curr. Psychiatry Rep. 22:65. [PubMed] [Google Scholar]
Demyttenaere One thousand., Bruffaerts R., Posada-Villa J., Gasquet I., Kovess V., Lepine J. P., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the Globe Health Organization World Mental Health Surveys. JAMA 291 2581–2590. 10.1001/jama.291.21.2581 [PubMed] [CrossRef] [Google Scholar]
Deshmukh S. R., Holmes J., Cardno A. (2018). Art therapy for people with dementia. Cochrane Database Syst. Rev. nine:D11073. [PMC free article] [PubMed] [Google Scholar]
Emery Thou. J. (2004). Art therapy as an intervention for Autism. Art Ther. Assoc. 21 143–147. 10.1080/07421656.2004.10129500 [CrossRef] [Google Scholar]
Evans Chiliad., Dubowski J. (2001). Art Therapy with Children on the Autistic Spectrum: Beyond Words. London: Jessica Kingsley Publishers, 113. [Google Scholar]
Faller H., Schmidt M. (2004). Prognostic value of depressive coping and low in survival of lung cancer patients. Psychooncology 13 359–363. ten.1002/pon.783 [PubMed] [CrossRef] [Google Scholar]
Forouzandeh North., Drees F., Forouzandeh Chiliad., Darakhshandeh Southward. (2020). The effect of interactive games compared to painting on preoperative feet in Iranian children: a randomized clinical trial. Complement. Ther. Clin. Pract. twoscore:101211. 10.1016/j.ctcp.2020.101211 [PubMed] [CrossRef] [Google Scholar]
Forzoni South., Perez Yard., Martignetti A., Crispino S. (2010). Fine art therapy with cancer patients during chemotherapy sessions: an analysis of the patients' perception of helpfulness. Palliat. Support. Intendance 8 41–48. 10.1017/s1478951509990691 [PubMed] [CrossRef] [Google Scholar]
Geschwind D. H., Levitt P. (2007). Autism spectrum disorders: developmental disconnection syndromes. Curr. Opin. Neurobiol. 17 103–111. 10.1016/j.conb.2007.01.009 [PubMed] [CrossRef] [Google Scholar]
Geue K., Richter R., Buttstädt M., Brähler E., Singer S. (2013). An art therapy intervention for cancer patients in the ambulant aftercare–results from a non-randomised controlled report. Eur. J. Cancer Care (Engl.) 22 345–352. 10.1111/ecc.12037 [PubMed] [CrossRef] [Google Scholar]
Götze H., Geue One thousand., Buttstädt Thou., Vocaliser South., Schwarz R. (2009). [Art therapy for cancer patients in outpatient care. Psychological distress and coping of the participants]. Forsch. Komplementmed. 16 28–33. [PubMed] [Google Scholar]
Guillemin M. (2004). Understanding illness: using drawings as a research method. Qual. Health Res. 14 272–289. ten.1177/1049732303260445 [PubMed] [CrossRef] [Google Scholar]
Gussak D. (2007). The effectiveness of art therapy in reducing low in prison house populations. Int J Offender Ther Comp Criminol 51 444–460. 10.1177/0306624x06294137 [PubMed] [CrossRef] [Google Scholar]
Hamer Yard., Chida Y., Molloy K. J. (2009). Psychological distress and cancer mortality. J. Psychosom. Res. 66 255–258. 10.1016/j.jpsychores.2008.11.002 [PubMed] [CrossRef] [Google Scholar]
Hattori H., Hattori C., Hokao C., Mizushima One thousand., Mase T. (2011). Controlled study on the cognitive and psychological effect of coloring and drawing in mild Alzheimer'due south affliction patients. Geriatr. Gerontol. Int. 11 431–437. 10.1111/j.1447-0594.2011.00698.x [PubMed] [CrossRef] [Google Scholar]
Heymann P., Gienger R., Hett A., Müller S., Laske C., Robens S., et al. (2018). Early detection of Alzheimer's disease based on the patient's creative drawing process: outset results with a novel neuropsychological testing method. J. Alzheimers Dis. 63 675–687. x.3233/jad-170946 [PubMed] [CrossRef] [Google Scholar]
Hongxia M., Shuying C., Chuqiao F., Haiying Z., Xuejiao West., et al. (2013). Relationsle-title>Relationship between psychological state and house-tree-person drawing characteristics of rehabilitation patients with schizophrenia. Chin. Gen. Pract. 16 2293–2295. [Google Scholar]
Hongyan Due west., JinJie Fifty. (2010). Rehabilitation consequence of painting therapy on chronic schizophrenia. Mentum. J. Health Psychol. 18 1419–1420. [Google Scholar]
Jalambadani Z. (2020). Art therapy based on painting therapy on the comeback of autistic children's social interactions in Iran. Indian J. Psychiatry 62 218–219. 10.4103/psychiatry.indianjpsychiatry_215_18 [PMC gratuitous commodity] [PubMed] [CrossRef] [Google Scholar]
Jianhua C., Xiaolu X. (2013). The experimental research on children with autism past intervening with painting therapy. J. Tangshan Teach. Coll. 35 127–130. [Google Scholar]
Kenbubpha Thou., Higgins I., Chan South. W., Wilson A. (2018). Promoting active ageing in older people with mental disorders living in the community: an integrative review. Int. J. Nurs. Pract. 24:e12624. 10.1111/ijn.12624 [PubMed] [CrossRef] [Google Scholar]
Kolliakou A., Joseph C., Ismail Thou., Atakan Z., Murray R. M. (2011). Why do patients with psychosis utilise cannabis and are they ready to modify their use? Int. J. Dev. Neurosci. 29 335–346. 10.1016/j.ijdevneu.2010.11.006 [PubMed] [CrossRef] [Google Scholar]
Lee J., Choi Yard. Y., Kim Y. B., Sun J., Park Eastward. J., Kim J. H., et al. (2017). Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients. Qual. Life Res. 26 707–715. 10.1007/s11136-016-1473-five [PubMed] [CrossRef] [Google Scholar]
Leevers H. J., Harris P. L. (1998). Drawing impossible entities: a mensurate of the imagination in children with autism, children with learning disabilities, and normal 4-yr-olds. J. Child Psychol. Psychiatry 39 399–410. ten.1111/1469-7610.00335 [PubMed] [CrossRef] [Google Scholar]
Lefèvre C., Ledoux Yard., Filbet M. (2016). Art therapy amidst palliative cancer patients: artful dimensions and impacts on symptoms. Palliat. Support. Care 14 376–380. 10.1017/s1478951515001017 [PubMed] [CrossRef] [Google Scholar]
Legrand A. P., Rivals I., Richard A., Apartis East., Roze Due east., Vidailhet M., et al. (2017). New insight in screw cartoon analysis methods–application to action tremor quantification. Clin. Neurophysiol. 128 1823–1834. x.1016/j.clinph.2017.07.002 [PubMed] [CrossRef] [Google Scholar]
Liebmann Thou., Weston South. (2015). Art Therapy with Physical Conditions. Philadelphia, PA: Jessica Kingsley Publishers. [Google Scholar]
Lin Thousand. H., Moh S. L., Kuo Y. C., Wu P. Y., Lin C. 50., Tsai M. H., et al. (2012). Fine art therapy for terminal cancer patients in a hospice palliative intendance unit in Taiwan. Palliat. Support. Intendance 10 51–57. x.1017/s1478951511000587 [PubMed] [CrossRef] [Google Scholar]
Low J., Goddard E., Melser J. (2009). Generativity and imagination in adisorder: prove from individual differences in children's impossible entity drawings. Br. J. Dev. Psychol. 27 425–444. 10.1348/026151008x334728 [PubMed] [CrossRef] [Google Scholar]
Malchiodi C. (2013). Fine art Therapy and Wellness Care. New York, NY: Guilford Press. [Google Scholar]
Mannheim East. Thousand., Helmes A., Weis J. (2013). [Dance/movement therapy in oncological rehabilitation]. Forsch. Komplementmed. 20 33–41. [PubMed] [Google Scholar]
Martin N. (2009). Art as an Early on Intervention Tool for Children with Autism. London: Jessica Kingsley. [Google Scholar]
Mimica N., Kaliniæ D. (2011). Art therapy may be benefitial for reducing stress–related behaviours in people with dementia–case report. Psychiatr. Danub. 23:125. [PubMed] [Google Scholar]
Min J. (2010). Application of painting therapy in the rehabilitation period of schizophrenia. Med. J. Mentum. Peoples Health 22 2012–2014. [Google Scholar]
Mirabella 1000. (2015). Is art therapy a reliable tool for rehabilitating people suffering from encephalon/mental diseases? J. Altern. Complement. Med. 21 196–199. 10.1089/acm.2014.0374 [PubMed] [CrossRef] [Google Scholar]
Montag C., Haase L., Seidel D., Bayerl G., Gallinat J., Herrmann U., et al. (2014). A pilot RCT of psychodynamic group art therapy for patients in astute psychotic episodes: feasibility, impact on symptoms and mentalising capacity. PLoS One 9:e112348. ten.1371/journal.pone.0112348 [PMC complimentary article] [PubMed] [CrossRef] [Google Scholar]
Nainis N., Paice J. A., Ratner J., Wirth J. H., Lai J., Shott Southward. (2006). Relieving symptoms in cancer: innovative use of art therapy. J. Pain Symptom Manage. 31 162–169. 10.1016/j.jpainsymman.2005.07.006 [PubMed] [CrossRef] [Google Scholar]
Narme P., Tonini A., Khatir F., Schiaratura L., Clément S., Samson South. (2012). [Non pharmacological handling for Alzheimer's illness: comparison betwixt musical and non-musical interventions]. Geriatr. Psychol. Neuropsychiatr. Vieil. 10 215–224. 10.1684/pnv.2012.0343 [PubMed] [CrossRef] [Google Scholar]
Nielsen S., Hageman I., Petersen A., Daniel Southward. I. F., Lau M., Winding C., et al. (2019). Do emotion regulation, attentional control, and attachment manner predict response to cognitive behavioral therapy for feet disorders?–An investigation in clinical settings. Psychother. Res. 29 999–1009. 10.1080/10503307.2018.1425933 [PubMed] [CrossRef] [Google Scholar]
Papangelo P., Pinzino M., Pelagatti S., Fabbri-Destro Chiliad., Narzisi A. (2020). Homo figure drawings in children with autism spectrum disorders: a possible window on the inner or the outer earth. Encephalon Sci. 10:398. 10.3390/brainsci10060398 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Petersen R. C., Caracciolo B., Brayne C., Gauthier S., Jelic V., Fratiglioni L. (2014). Mild cognitive impairment: a concept in development. J. Intern. Med. 275 214–228. [PMC complimentary article] [PubMed] [Google Scholar]
Superhighway A. A. (2013). The event of fine art therapy on cerebral operation amidst ethnically various older adults. J. Am. Fine art Ther. Assoc. 30 159–168. 10.1080/07421656.2014.847049 [CrossRef] [Google Scholar]
Pongan Eastward., Tillmann B., Leveque Y., Trombert B., Getenet J. C., Auguste N., et al. (2017). Tin can musical or painting interventions better chronic pain, mood, quality of life, and cognition in patients with mild Alzheimer's disease? Evidence from a randomized controlled trial. J. Alzheimers Dis. 60 663–677. x.3233/jad-170410 [PubMed] [CrossRef] [Google Scholar]
Richardson P., Jones Thousand., Evans C., Stevens P., Rowe A. (2007). Exploratory RCT of art therapy as an adjunctive handling in schizophrenia. J. Ment. Health 16 483–491. ten.1080/09638230701483111 [CrossRef] [Google Scholar]
Richardson P., Jones 1000., Evans C., Stevens P., Rowe A. (2009). Exploratory RCT of art therapy as an adjunctive treatment in schizophrenia. J Ment. Health sixteen 483–491. [Google Scholar]
Ruiz M. I., Aceituno D., Rada G. (2017). Art therapy for schizophrenia? Medwave 17:e6845. [PubMed] [Google Scholar]
Runde P. (2008). Clinical application of painting therapy in middle school students with mood disorders. Chin. J. Wellness Psychol. 27 749–750. [Google Scholar]
Rusted J., Sheppard 50., Waller D. A. (2016). Multi-heart randomized control group trial on the use of art therapy for older people with dementia. Grouping Anal. 39 517–536. 10.1177/0533316406071447 [CrossRef] [Google Scholar]
Salmon P. L. (1993). Viewing the client'southward world through drawings. J. Holist. Nurs. xi 21–41. 10.1177/089801019301100104 [PubMed] [CrossRef] [Google Scholar]
Steinbauer M., Taucher J. (2001). [Paintings and their progress by psychiatric inpatients within the concept of integrative art therapy]. Wien. Med. Wochenschr. 151 375–379. [PubMed] [Google Scholar]
Steinbauer M., Taucher J., Zapotoczky H. G. (1999). [Integrative painting therapy. A therapeutic concept for psychiatric inpatients at the Academy clinic in Graz]. Wien. Klin. Wochenschr. 111 525–532. [PubMed] [Google Scholar]
Teglbjaerg H. S. (2011). Fine art therapy may reduce psychopathology in schizophrenia by strengthening the patients' sense of cocky: a qualitative extended instance report. Psychopathology 44 314–318. 10.1159/000325025 [PubMed] [CrossRef] [Google Scholar]
Ten E. K., Muller U. (2018). Cartoon links betwixt the autism cognitive profile and imagination: executive office and processing bias in imaginative drawings by children with and without autism. Autism 22 149–160. ten.1177/1362361316668293 [PubMed] [CrossRef] [Google Scholar]
Thyme K. E., Sundin E. C., Wiberg B., Oster I., Aström Southward., Lindh J. (2009). Individual cursory art therapy tin can be helpful for women with breast cancer: a randomized controlled clinical study. Palliat. Support. Care 7 87–95. 10.1017/s147895150900011x [PubMed] [CrossRef] [Google Scholar]
Tong J., Yu W., Fan X., Sun X., Zhang J., Zhang J., et al. (2020). Impact of group art therapy using traditional Chinese materials on self-efficacy and social function for individuals diagnosed with schizophrenia. Front. Psychol. 11:571124. 10.3389/fpsyg.2020.571124 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
van Geffen E. C., van der Wal Southward. Westward., van Hulten R., de Groot M. C., Egberts A. C., Heerdink E. R. (2007). Evaluation of patients' experiences with antidepressants reported past means of a medicine reporting arrangement. Eur. J. Clin. Pharmacol. 63 1193–1199.10.1007/s00228-007-0375-four [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Wang Y., Jiepeng 50., Aihua Z., Runjuan G., Lei Z. (2011). Study on the application value of painting therapy in the treatment of depression. Med. J. Mentum. Peoples Health 23 1974–1976. [Google Scholar]
Wen Z., Zhaoming G. (2009). A preliminary endeavour of painting art therapy for autistic children. Inner Mongol. J. Tradit. Mentum. Med. 28 24–25. [Google Scholar]
Whiteford H. A., Degenhardt L., Rehm J., Baxter A. J., Ferrari A. J., Erskine H. E., et al. (2013). Global brunt of disease attributable to mental and substance apply disorders: findings from the Global Burden of Disease Report 2010. Lancet 382 1575–1586. ten.1016/s0140-6736(13)61611-6 [PubMed] [CrossRef] [Google Scholar]
Wilk M., Pachalska Thousand., Lipowska M., Herman-Sucharska I., Makarowski R., Mirski A., et al. (2010). Speech intelligibility in cerebral palsy children attending an art therapy program. Med. Sci. Monit. 16 R222–R231. [PubMed] [Google Scholar]
Witkoski South. A., Chaves Yard. (2007). Evaluation of artwork produced past Alzheimer's disease outpatients in a pilot art therapy programme. Bewilder. Neuropsychol. one 217–221. x.1590/s1980-57642008dn10200016 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Xu M., Chen Thousand., Zhou Q., Li Due north., Zheng X. (2017). Prevalence of mental disorders among older Chinese people in Tianjin City. Tin. J. Psychiatry 62 778–786. 10.1177/0706743717727241 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Yu J., Rawtaer I., Goh Fifty. Thousand., Kumar A. P., Feng L., Kua E. H., et al. (2021). The art of remediating age-related cognitive pass up: art therapy enhances cognition and increases cortical thickness in mild cognitive harm. J. Int. Neuropsychol. Soc. 27 79–88. 10.1017/s1355617720000697 [PubMed] [CrossRef] [Google Scholar]
Zhenhai Due north., Yunhua C. (2011). An experimental report on the improvement of depression in Obese female college students by painting therapy. Chin. J. Sch. Health 32 558–559. [Google Scholar]
Zschucke E., Gaudlitz K., Strohle A. (2013). Exercise and physical action in mental disorders: clinical and experimental prove. J. Prev. Med. Public Health 46(Suppl. ane) S12–S21. [PMC free article] [PubMed] [Google Scholar]

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