Assessment tools
Forty studies included in this systematic review used a self-reporting
validated outcome measurement tool and two studies performed a
structured diagnostic interview for reporting either depressive or
anxiety symptoms or both. Five studies reported a depression or anxiety
disorder based on medical records (ICD-9 diagnoses). Various outcome
measures were used of which the details are listed in appendixS4 [74-93]. With regard to the assessment of depressive
symptoms, the Hospital Anxiety and Depression Scale (HADS) or Becks
Depression Inventory (BDI) were most frequently used [76,83].
Concerning assessment of anxiety symptoms, the most commonly used tools
were the HADS or the State-Trait Anxiety Inventory (STAI) [83,92].
Assessment of anxiety symptoms included the evaluation of either
general, state, trait and/or phobic anxiety. Instruments developed for
the global assessment of anxiety focus on the assessment of mood,
cognition and behaviour, whereas tools for assessing phobic anxiety more
often include somatic symptoms of anxiety [94]. State anxiety
questionnaires evaluate anxiety as a current emotional state, whereas
trait anxiety questionnaires evaluate individual differences in anxiety
as a personality trait [95].