The Effect of Mandala Coloring on State Anxiety: A Systematic Review and Meta-Analysis

This meta-analysis assessed the effectiveness of mandala coloring, compared with free drawing, on state anxiety in adults. A systematic search for studies yielded eight studies, which constituted a total of 578 participants, with 289 in the mandala coloring group and 289 in the free drawing group. The results indicated that coloring mandala designs was not found to reduce state anxiety significantly more than free drawing. Larger effect sizes were found in the studies with lower precision, indicating some evidence of bias toward finding an effect. The findings suggest that mandala coloring and free drawing are equally effective coloring techniques to achieve anxiety reduction. More high-quality studies are warranted before any recommendations can be made with confidence.