Immersive metaverse art as a psychological intervention for depression and anxiety: a narrative review and multilevel model integrating engagement, cultural identity, and neurocognitive mechanisms.

Depression and anxiety rank among the leading causes of global disability, yet traditional treatments reach only a minority of affected individuals. The COVID-19 pandemic further exacerbated this crisis, triggering a ~ 25% worldwide surge in anxiety and depression prevalence. In parallel, immersive digital environments (the "metaverse") are maturing as platforms for creative expression and social connection. This review proposes that immersive metaverse art - interactive art experiences in VR/AR - can act as a multilevel psychobehavioral modulator. We integrate recent evidence showing that such experiences enhance engagement (flow, presence), enable identity exploration (customizable avatars, cultural narratives), and engage neurocognitive systems (reward, attention, regulation). Empirical studies of VR art interventions report acute mood improvements, stress reduction, and greater social connectedness. We synthesize these findings into a conceptual model linking core components (immersion, creative agency, social avatar, cultural symbolism) to mediating processes (flow, meaning-making, belonging) and outcomes (symptom relief, emotional regulation, behavioral activation). Rather than examining these domains as separate interdisciplinary themes, the review integrates them within a unified clinical framework focused on transdiagnostic mechanisms relevant to depression and anxiety. We compare immersive art therapy with traditional art therapy, noting unique advantages (scalability, personalization) and novel risks (overdependence, identity diffusion). Finally, we outline translational pathways - e.g. integrating VR art with cognitive therapies and highlight the need for rigorous trials and cross-cultural validation. Overall, immersive metaverse art emerges as a promising, if nascent, approach to mental health intervention, warranting further empirical and ethical scrutiny.