Screening for depression: a systematic review and meta-analysis

Area of Science:

• Public Health
• Preventive Medicine
• Mental Health Research

Background:

• The Canadian Task Force on Preventive Health Care has guidelines for screening adults at risk for depression.
• This study aimed to provide evidence for an updated guideline on depression screening effectiveness.

Purpose of the Study:

• To evaluate the literature on the effectiveness of screening for depression in adults aged 18 years and older.
• To inform an update of the Canadian Task Force on Preventive Health Care guideline.

Main Methods:

• A systematic literature search was conducted from 1994 to May 2012 across multiple electronic databases.
• Included studies were randomized controlled trials, observational studies, and systematic reviews assessing benefits or harms of depression screening.
• Meta-analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used for data analysis and quality assessment.

Main Results:

• Five quasi-experimental studies on community-based depression screening in rural Japan were included.
• Meta-analysis indicated a protective effect of screening on overall suicide completion (RRR 0.50), especially for women (RRR 0.37), but not men (RRR 0.67).
• The overall quality of evidence was rated as very low, and no studies on harms of screening met inclusion criteria.

Conclusions:

• There is very limited research evidence to draw conclusions on the effectiveness of depression screening in average or high-risk adult populations.
• Further research is needed to establish the benefits and harms of depression screening.