CoChat
Sign Up
Cited by 22Art Therapy and Mental HealthMusic Therapy and HealthColor perception and design

Randomized Controlled Trial of Adult Therapeutic Coloring for the Management of Significant Anxiety in the Emergency Department

Rajendran, Naveendran, Mitra, Tatum Priyambada, Shahrestani, Sara, Coggins, Andrew·2020·Academic Emergency Medicine
DOI 10.1111/acem.13838
Open this paper in CoChat — free account

Abstract

Background: Anxiety and acute distress are significant concerns in the emergency department ( ED ). Adult coloring books are often utilized as an effective means of relaxation in waiting rooms and newsstands, but there are no reported randomized trials examining their effectiveness as a treatment for anxiety. Methods: We set out to examine the effectiveness of adult coloring books using a randomized placebo‐controlled trial at a university‐affiliated tertiary ED . Anxiety was measured using a validated self‐reporting score, the Hospital Anxiety and Depression Scale ( HADS ‐A), with a range of 0 to 21. Patients with HADS ‐A ≥ 7 were randomly assigned to either an adult coloring pack ( n = 26) or placebo pack ( n = 27). The primary outcome measure was the within‐patient change in HADS ‐A scores following 2 hours of exposure. Results: A convenience sample of 117 patients were screened, and 53 patients were randomized. Characteristics of allocated groups were similar in terms of sex, diagnosis, and ethnicity. A higher proportion of intervention subjects spent ≥1 hour engaged with their activity (46.2% vs. 4.0%, p = 0.01). For the primary outcome measure, the mean within‐patient decrease in HADS ‐A score at 2 hours for intervention subjects was 3.7 (95% confidence interval [ CI ] = 2.4 to 5.1, p < 0.001) versus a decrease of 0.3 (95% CI = –0.6 to 1.2, p = 0.51) in the placebo group. Conclusions: Among ED patients, exposure to adult coloring books resulted in lower self‐reported levels of anxiety at 2 hours compared to placebo.

Integrity signals

Registry

Crossref · 10.1111/acem.13838

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Existing literature examining the effectiveness of art therapy has shown some positive results across a wide variety of treatment indications, such as the treatment of depression, anxiety, psychosis, the enhancement of mental wellbeing, and the complementary treatment of cancer.

    “The existing literature examining the effectiveness of art therapy has shown some positive results across a wide variety of treatment indications, such as the treatment of depression [3, 18], anxiety [19, 20], psychosis [21], the enhancement of mental wellbeing [22], and the complementary treatment of cancer [15, 23].”

    From The effect of active visual art therapy on health outcomes: protocol of a systematic review of randomised controlled trials (2022) · cites this paper as [20]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Rajendran, N., Mitra, T. P., Shahrestani, S., & Coggins, A.
Affiliations
The University of Sydney (AU)
Corresponding author
Coggins, Andrew
ORCID
Venue
Academic Emergency Medicine
Publisher
Wiley
Published
2020-01-20
Volume
27
Issue
2
Pages
92-99
ISSN
  • 1069-6563 (ISSN-L)
  • 1553-2712
DOI
10.1111/acem.13838
OpenAlex
W3003122537
Cited by
22
References
36
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 3
FWCI
27.14
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Academic Emergency Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Arts and Humanities › Conservation › Art Therapy and Mental Health
  • Social Sciences › Psychology › Social Psychology › Music Therapy and Health
  • Social Sciences › Psychology › Social Psychology › Color perception and design
Keywords
anxiety reduction, emergency department patients, acute distress, relaxation, Hospital Anxiety and Depression Scale, placebo-controlled intervention, patient engagement
MeSH terms
Adult, Anxiety, Art Therapy, Emergency Service, Hospital, Female, Humans, Male, Middle Aged, Time Factors, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review