Screening for depression
Pignone M, Gaynes B N, Rushton J L, Mulrow C D, Orleans C T, Whitener B L, Mills C, Lohr K N
Record ID 32003001103
English
Authors' objectives:
To review systematically the literature regarding the effectiveness of screening for depressive disorders in primary care settings.
Authors' results and conclusions:
Studies examining the diagnostic accuracy of depression screening instruments generally have found sensitivity results of 80% to 90% and specificity results from 70% to 85% in adults and 60% to 100% and 60% to 85% in children.
For adult primary care patients with major depression, treatment with pharmacotherapy or psychotherapy reduces symptom duration and severity. Pharmacotherapy and psychotherapy appear to produce a similar magnitude of effect. Approximately 4 patients must be treated to produce 1 additional clinical remission. Cognitive-behavioral therapy appears to reduce depression scores in children and adolescents. Data on pharmacotherapy for children and adolescents are mixed: tricyclic agents appear ineffective, and data for selective serotonin reuptake inhibitor drugs are inconclusive but promising.
Feedback of screening results to providers appears to increase recognition of depression in adults compared with usual care but its effect on treatment and clinical outcomes are mixed. Screening appears to be more effective when coupled with systematic efforts to ensure adequate treatment and follow-up. The effect of screening has not been evaluated in children.
Other than medication side effects, little evidence is available about the potential harms of screening and treatment of depression.
Authors' recommendations:
Accurate screening tests and effective therapies for depression are available. Screening for depression can improve outcomes compared with usual care in adults, particularly when coupled with efforts to ensure adequate treatment and follow-up. The effect of screening in children and adolescents is unknown.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.ahrq.gov/clinic/uspstf/uspsdepr.htm
Year Published:
2002
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Mass Screening
- Depression
- Depressive Disorder
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.