Identifying and recommending validated measures to assess depression and anxiety outcomes in the field of Arts and Health

Nik Ilya^1*Jean CJ Liu^2,3,4Kathleen Rose Agres^1*

• ¹National University of Singapore, Singapore, Singapore
• ²Centre for Evidence and Implementation, Singapore, Singapore
• ³Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
• ⁴Yale-NUS College, National University of Singapore, Singapore, Singapore

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 is still limited. Various resources have been published to encourage an expansion and improvement in 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 provide recommendations, nor 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.: We used a two-part literature review to identify depression and anxiety scales suitable for arts and health interventions. The review begins by uncovering canonical 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 in terms of the use of validated tools to assess mental health outcomes. Results: 44 depression and 81 anxiety scales were uncovered from 31 review papers. Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI) emerged as the most widely used scales measuring depression symptoms. State-Trait Anxiety Inventory (STAI) emerged as the most widely used scale measuring anxiety symptoms. Discussion: We found that BDI was primarily used to evaluate performing art interventions, STAI was used for performing and visual art interventions, and HADS was used widely 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 towards more rigorous evaluation methods.