Table 1 Criteria for inclusion and exclusion of studies in the general adult review

Population

Key question 1: patients who are 18 years and older

Key question 1a: patients who are 18 years and older selected for screening because they have characteristics that may suggest an elevated risk of depression*

*Characteristics as defined in primary studies (e.g. trauma early in life, a family history of depression)

- If > 20% of the study population have a recent history of depression, have a current diagnosis, or are receiving treatment for depression or other mental disorders (unless results are provided separately from the population of interest)

- Seeking services due to symptoms of mental disorders

- Receiving assessment or care in psychiatric or mental health settings

Intervention

Interventions that use a single question, small sets of questions, or a screening questionnaire (validated or non-validated) with a pre-defined cut-off score to identify patients who may have depression, but who have not reported their symptoms to healthcare providers or who have otherwise not been identified as possibly depressed by healthcare providers

Interventions that, in addition to screening, include depression care referral or treatment options that are not available to patients identified as depressed in the non-screening trial arm are excluded.

Comparator

No depression screening

Patients in comparator trial arms may be administered depression symptom questionnaires for the purpose of baseline or outcome assessments as long as scores are not provided to the patients or healthcare providers.

Outcomes

• Symptoms of depression (continuous or dichotomous) or diagnosis of MDD (using a validated diagnostic interview)

• Health-related quality of life

• Day-to-day functionality

• Lost time at work/school

• Impact on lifestyle behaviour (alcohol abuse, smoking, drugs, gambling, etc.)

• Suicidality (suicide ideation, attempt or completion)

• False-positive result (positive screen in the absence of depressive disorder), overdiagnosis, or overtreatment

• Labelling/stigma

• Harms of treatment

Timing

Published from May 2012 to the date the search is run

Study design

Randomized controlled trials (RCTs)* including cluster-controlled trials

*Trials of screening in which patient eligibility is determined and then patients are enrolled prior to randomization (i.e., to screening or to no screening). Similar depression management and treatment resources are provided to patients in the screening arm of the trial who were identified as depressed as well as patients in either the screening or non-screening arms of the trial who were identified as depressed via other methods (e.g. unaided clinician diagnosis, patient report) [40]

- RCTs where patient eligibility is determined and patients are enrolled after randomization

- Non-RCTs, controlled before-after, interrupted times series, cohort studies, case-control studies, cross-sectional studies, case series, case reports, and other publication types (editorials, commentaries, notes, letter, opinions)

Setting

Primary care or other non-mental health clinic settings, including specialty clinics such as rheumatology, obstetrics, and gynaecology.

Studies conducted in mental health or psychiatric settings are excluded.

Language

English and French