The use of art therapy to detect depression and post‐traumatic stress disorder in pediatric and young adult renal transplant recipients

Abstract

Pediatric and young adult renal transplant recipients may experience feelings of depression and emotional trauma. A study was conducted to (1) determine the prevalence of depression and emotional trauma and (2) assess the utility of the Formal Elements of Art Therapy Scale (FEATS). Sixty-four renal transplant recipients, 6-21 yr of age, were evaluated using self-report measures (CDI and Davidson) and art-based assessments. Subject art was analyzed by art therapists using seven of the 14 elements of the (FEATS), to assess depression. Unlike CDI and Davidson self-report testing, all patients were able to complete the art-based directives. When self-report measures and art-based assessments were combined, 36% of the study population had testing results consistent with depression and/or post-traumatic stress. The FEATS assessments identified a subset of patients who were not identified using the self-report measures. There was a correlation between CDI and Davidson scores (p < 0.0001), Davidson scores correlated with hospital days (p = 0.05), and FEATS correlated with height Z score (p = 0.04) and donor type (p = 0.01). Patients who required psychological interventions including antidepressant therapy, psychological counseling and psychiatric hospitalization during the year after the study were identified as depressed. Sensitivity for FEATS and CDI were 22 and 50% respectively. The results suggest that while art therapy may be of utility in the identification of pediatric and young adult transplant recipients who are suffering from depression, FEATS analysis appears to lack sufficient sensitivity to warrant its use in this population. Study of other quantitative art-based assessment techniques may be warranted.

Mapping the waters: A scoping review of the use of visual arts in pediatric populations with health conditions

“…The disciplinary background of the first authors varied and included art therapists (n ¼ 2) (Lyshak-Stelzer, Singer, St. John, & Chemtob, 2007;Martin, 2008); nurses (n ¼ 3) (Brewer, Gleditsch, Syblik, Tietjens, & Vacik, 2006;Madden, Mowry, Gao, McGuire Cullen, & Foreman, 2010;Rollins, 2005); psychotherapists (n ¼ 2) (Epp, 2008;Wallace et al, 2004); psychologists (n ¼ 2) (Favara-Scacco, Smirne, Schilirò, & Di Cataldo, 2001;Stefanatou, 2008); counsellors (n ¼ 1) (Beebe, Gelfand, & Bender, 2010); music therapists (n ¼ 1) (Colwell, Davis, & Schroeder, 2005); learning and research services from the department of pediatrics (n ¼ 1) (Kortesluoma, Punamäki, & Nikkonen, 2008); interior designers (n ¼ 1) (Eisen, Ulrich, Shepley, Varni, & Sherman, 2008); social workers (n ¼ 1) (Hamama & Ronen, 2009), anthroposophic medical doctors (n ¼ 1) (Hamre et al, 2009); and population health providers (n ¼ 1) (Mueller, Alie, Jonas, Brown, & Sherr, 2011). Overlap between disciplinary backgrounds of first authors was noted, predominantly within disciplines of art therapy and psychology (e.g.…”

“…Fourteen of the 16 studies included both child and adolescent participants. Of these, two studies (Martin, 2008;Wallace et al, 2004) included participants over 18 years of age. One study included participants within the specific age range of 11-12 years (Hamama & Ronen, 2009) and only one study included only adolescent participants (Lyshak-Stelzer et al, 2007).…”

“…Eleven of the 16 studies took place in hospital environments (Brewer et al, 2006;Colwell et al, 2005;Eisen et al, 2008;Favara-Scacco et al, 2001;Hamre et al, 2009;Kortesluoma et al, 2008;Lyshak-Stelzer et al, 2007;Madden et al, 2010;Rollins, 2005;Stefanatou, 2008;Wallace et al, 2004). Of these, the majority (n ¼ 8) occurred in inpatient settings (Brewer et al, 2006;Colwell et al, 2005;Eisen et al, 2008;FavaraScacco et al, 2001;Kortesluoma et al, 2008;Lyshak-Stelzer et al, 2007;Rollins, 2005;Stefanatou, 2008).…”

“…Of these, the majority (n ¼ 8) occurred in inpatient settings (Brewer et al, 2006;Colwell et al, 2005;Eisen et al, 2008;FavaraScacco et al, 2001;Kortesluoma et al, 2008;Lyshak-Stelzer et al, 2007;Rollins, 2005;Stefanatou, 2008). Three studies took place in outpatient environments (Hamre et al, 2009;Madden et al, 2010;Wallace et al, 2004).…”

“…characteristics of the intervention space) that the artistic intervention was delivered were not generally included (n ¼ 12). Martin (2008) provided a brief description of the participant room used for the arts-based intervention, as did Rollins (2005), Stefanatou (2008) and Wallace et al (2004). Martin (2008) described that children participated "on site in a quiet room with a table for drawing" (p. 17).…”