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Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]

Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review [Internet]

Evidence Syntheses - Agency for Healthcare Research and Quality (US)

Version: December 2009

Introduction

We conducted this systematic review to aid the United States Preventive Services Task Force (USPSTF) in updating its 2002 recommendation for adult depression screening in primary care. We focused on gaps in evidence identified by the previous review and on integrating relevant research published in the interim. Questions that the USPSTF judged to have strong, coherent evidence in the previous review are not re-addressed here. Specifically, we did not update evidence regarding the accuracy of screening instruments for identifying depressed adults and older adults in primary care, nor treatment of adult depression with antidepressants or psychotherapy. We updated direct evidence that primary care depression screening programs improve health outcomes and examined evidence for the efficacy of depression treatment in older adults and evidence for the harms of screening and adverse events from antidepressant treatment in adults and older adults.

Results

Summary of findings. One fair-quality randomized controlled trial of primary care patients identified by the previous systematic review compared screening’s impact with a non-screened usual care group (Table 3). Nine hundred sixty-nine patients were randomized, 863 of whom completed a post-visit interview. A subset of the randomized patients from one of the two sites, over-sampling those with depressive symptomatology at baseline, were re-assessed after 3-months.

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