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Table 2 Eligibility criteria for inclusion and exclusion of studies

From: Screening for depression among the general adult population and in women during pregnancy or the first-year postpartum: two systematic reviews to inform a guideline of the Canadian Task Force on Preventive Health Care

  Inclusion criteria Exclusion criteria
General adult population (A) Pregnancy and postpartum (B)
Population Key question 1: Patients who are 18 years of age and older
Key question 1a: Patients who are 18 years of age and older selected for screening because they have characteristics that may suggest elevated risk of depression
Characteristics as defined in primary studies (e.g., trauma early in life, a family history of depression)
Key question 1: Patients during pregnancy and up to 1 year postpartum of any age
Key question 1a: Patients during pregnancy and up to 1 year postpartum selected for screening because they have characteristics that may suggest elevated risk of depression
Characteristics as defined in primary studies (e.g., trauma early in life, a family history of depression)
• If >20% of study sample 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) (A and B)
• Women with any history of depression during pregnancy or the postpartum period (B)b
• Those seeking services due to symptoms of mental disorders (A and B)
• Those receiving assessment or care in psychiatric or mental health settings (A and B)
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 no screening trial arm
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 lifea
• Day-to-day functionality
• Lost time at work/school
• Impact on lifestyle behavior (alcohol abuse, smoking, drugs, gambling, etc.)
• Suicidality (suicide ideation, attempt or completion)
• False-positive result (positive screen in absence of depressive disorder), overdiagnosis, or overtreatment
• Labeling/stigma
• Harms of treatment
Mental health outcomes
• Symptoms of depression (continuous or dichotomous) or diagnosis of MDD (using a validated diagnostic interview)
• Health-related quality of lifea
• Suicidality (suicide ideation, attempt, or completion)
• False-positive screens (positive screens in absence of depressive disorder), overdiagnosis, or overtreatment
• Labeling/stigma
• Harms of treatment
Parenting outcomes
• Relationship with partner and other supports
• Reported/observed capacity to parent (attachment, responsiveness to infant, positive regard of infant/fetus)
• Mother-child interactions including mutual touching, smiling, vocalizations, and impact on other children
Infant outcomes
• Infant health and development (i.e., developmental delay; failure to thrive) cognitive, emotional, motor, and neural functioning and development
• Infant responsiveness
 
Timing From literature inception From literature inception  
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 the non-screening arms of the trial who were identified as depressed via other methods (e.g., unaided clinician diagnosis, patient report) [28]
RCTs where patient eligibility is determined, and patients are enrolled after randomization.
Non-RCTs, controlled before-after studies, interrupted time series, cohort studies, case-control studies, cross-sectional studies, case series, case reports, abstracts, 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 gynecology Primary care or other non-mental health clinic settings, including specialty clinics such as obstetrical, maternal-fetal medicine, and pediatric clinics Studies conducted in mental health or psychiatric settings
Language English and French  
  1. MDD major depressive disorder, RCT randomized controlled trial
  2. aValidated tools
  3. bWomen with a history of depression in these periods should be assessed clinically and not just be part of a screening pool