Matthew Hotopf, MD
What is the effectiveness of screening or case-finding questionnaires used alone in the detection and management of depression?
Selected studies compared standardized screening or case-finding instruments with usual care for depression in nonpsychiatric settings (e.g., general hospital or primary care). Studies that had substantial enhancements in the process of care (e.g., case managers, nursing interventions, or collaborative care) were excluded. Outcomes were recognition of depression, use of any intervention for depression (pharmacologic or psychosocial intervention, or active referral to a specialist), and outcomes of depression.
Medline; EMBASE/Excerpta Medica; CINAHL; Cochrane Depression, Anxiety, and Neurosis Group Trials Register; Cochrane Database of Systematic Reviews; Cochrane Library; National Health Service Economic Evaluations Database; Database of Reviews of Effectiveness; British Nursing Index and Royal College of Nursing; PsycLIT; and EconLIT (all to December 2007) were searched for randomized controlled trials (RCTs). 16 RCTs (n = 7576) met the selection criteria.
Meta-analysis showed that screening and case finding led to increased recognition of depression compared with usual care (Table). Groups did not differ for use of any intervention for depression or outcome of depression (Table).
Screening or case-finding questionnaires used alone are not effective in the management of depression.
Screening or case-finding instruments vs usual care in depression*
*Abbreviations defined in Glossary. Weighted event rates, RBI, NNT, and CI calculated from control event rate and relative risks in article using a random-effects model.
†Duration of follow-up based on 9 studies.
Matthew Hotopf. Review: Screening or case-finding questionnaires used alone are not effective in the management of depression. Ann Intern Med. 2008;149:JC1–9. doi: 10.7326/0003-4819-149-2-200807150-02009
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Published: Ann Intern Med. 2008;149(2):JC1-9.
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