Identifying and recommending validated measures to assess depression and anxiety outcomes in the field of arts and health

Abstract

Introduction: Interest in the use of arts-based interventions to improve mental health outcomes has been emerging in healthcare and community settings. However, rigorous evaluation and research on the effectiveness of these interventions are still limited. Various resources have been published to encourage an expansion and improvement in the quality of the evidence base in this intersectional field. Yet, many of these resources either stop short of recommending validated outcome measures or provide justifications when they do so, nor do they identify the prevalence of use of these outcome measures. We provide practitioners in the field with recommended measures, identified through a prevalence analysis in the literature, and the associated considerations that practitioners should consider when choosing these scales. Materials and methods: We conducted a two-part literature review to identify depression and anxiety scales suitable for arts and health interventions. The review begins by identifying canonically validated tools used in medical and health research to document depression and anxiety symptoms. The second part of the review documents existing usage rates of each scale in studies involving arts and health interventions across 18 arts domains to provide a state of the field regarding the use of validated tools to assess mental health outcomes. Results: A total of 44 depression and 81 anxiety scales were identified from 31 review papers. The Hospital Anxiety and Depression Scale (HADS) and the Beck Depression Inventory (BDI) emerged as the most widely used scales for measuring depression symptoms. The State-Trait Anxiety Inventory (STAI) was identified as the most frequently used scale for measuring anxiety symptoms. Discussion: We found that the BDI was primarily used to evaluate performing arts interventions, the STAI was used for performing and visual art interventions, and the HADS was widely used across all arts domains. Our findings highlight key measures for the field, and we provide recommendations for their use, supporting arts and health practitioners in moving toward more rigorous evaluation methods.

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