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Objective: Depression screening among children and adolescents is controversial. In 2009, the United States Preventive Services Task Force first recommended routine depression screening for adolescents, and this recommendation was reiterated in 2016. However, no randomized controlled trials (RCTs) of screening were identified in the original 2009 systematic review or in an updated review through February 2015. The objective of this systematic review was to provide a current evaluation to determine whether there is evidence from RCTs that depression screening in childhood and adolescence improves depression outcomes., Method: Data sources included the MEDLINE, MEDLINE In-Process, EMBASE, PsycINFO, Cochrane CENTRAL and LILACS databases searched February 2, 2017. Eligible studies had to be RCTs that compared depression outcomes between children or adolescents aged 6 to 18 years who underwent depression screening and those who did not., Results: Of 552 unique title/abstracts, none received full-text review. No RCTs that investigated the effects of screening on depression outcomes in children or adolescents were identified., Conclusions: There is no direct RCT evidence that supports depression screening among children and adolescents. Groups that consider recommending screening should carefully consider potential harms, as well as the use of scarce health resources, that would occur with the implementation of screening programs.

Objective: Concerns have been raised that primary studies of diagnostic accuracy of depression screening tools may exaggerate estimates of accuracy and that this could also influence the results of meta-analyses. No studies, however, have evaluated the quality of meta-analyses of depression screening tools. Our objective was to evaluate the quality of meta-analyses of the diagnostic accuracy of depression screening tools., Methods: We searched MEDLINE and PsycINFO from January 1, 2005 through March 13, 2016 for recent meta-analyses in any language on the diagnostic accuracy of depression screening tools. Two reviewers independently assessed methodological quality using the AMSTAR tool with appropriate adaptations made for studies of diagnostic test accuracy., Results: We identified 21 eligible meta-analyses. The majority provided a list of included studies (100%), included a comprehensive literature search (95%) and assessed risk of bias of included studies (71%). Meta-analyses less consistently included non-published evidence (38%), listed excluded studies (33%), incorporated risk of bias findings into conclusions (33%), and assessed selective cutoff reporting (29%). Meta-analyses rarely reported that duplicate study selection or data extraction occurred (14%), mentioned 'a priori' protocols (10%), or reported on conflicts of interest (0%) or funding sources (0%) of primary studies. Only 6 of 21 included meta-analyses complied with at least 7 of 14 adapted AMSTAR items., Conclusions: The methodological quality of most meta-analyses of the diagnostic test accuracy of depression screening tools is suboptimal. Improving quality will reduce the risk of inaccurate estimates of accuracy and inappropriate inferences., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: The United States Preventive Services Task Force (USPSTF) recommends screening adults for depression in primary care settings when staff-assisted depression management programs are available. This recommendation, however, is based on evidence from depression management programs conducted with patients already identified as depressed, even though screening is intended to identify depressed patients not already recognized or treated. The objective of this systematic review was to evaluate whether there is evidence from randomized controlled trials (RCTs) that depression screening benefits patients in primary care, using an explicit definition of screening., Methods: We re-evaluated RCTs included in the 2009 USPSTF evidence review on depression screening, including only trials that compared depression outcomes between screened and non-screened patients and met the following three criteria: determined patient eligibility and randomized prior to screening; excluded patients already diagnosed with a recent episode of depression or already being treated for depression; and provided the same level of depression treatment services to patients identified as depressed in the screening and non-screening trial arms. We also reviewed studies included in a recent Cochrane systematic review, but not the USPSTF review; conducted a focused search to update the USPSTF review; and reviewed trial registries., Results: Of the nine RCTs included in the USPSTF review, four fulfilled none of three criteria for a test of depression screening, four fulfilled one of three criteria, and one fulfilled two of three criteria. There were two additional RCTs included only in the Cochrane review, and each fulfilled one of three criteria. No eligible RCTs were found via the updated review., Conclusions: The USPSTF recommendation to screen adults for depression in primary care settings when staff-assisted depression management programs are available is not supported by evidence from any RCTs that are directly relevant to the recommendation. The USPSTF should re-evaluate this recommendation. Please see related article: http://www.biomedcentral.com/1741-7015/12/14 REGISTRATION: PROSPERO (#CRD42013004276).