Table 2 KQ1 and KQ1a eligibility criteria (benefits and harms of screening)

Population

KQ1: Patients who are up to and including 17 years of age.

KQ1a: Patients who are up to and including 17 years of age selected for screening because they have characteristics that may suggest elevated risk of depression​.

For both KQs, caregivers may respond to screening questions on behalf of children. Onset of adolescence will be considered as being age 12.

Characteristics as defined in primary studies.

>20% of the study sample are adults (18 years and older), 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 sample of interest).

Members of the study sample are seeking services due to symptoms of mental disorders.

Members of the study sample are receiving assessment or care in psychiatric or mental health settings.

Members of the study sample are currently pregnant or have given birth in the past year.

Intervention

Screening tools that use a single question, a small set 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 previously reported their symptoms to healthcare providers or who have otherwise not been identified as possibly depressed by healthcare providers.

Patients and/or their guardians have the ability to answer screening tool questions.

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

Comparator

No depression screening.

Patients in comparator arms may be administered depression symptom questionnaires for the purpose of baseline or outcome assessments if scores are not provided to the patients or healthcare providers prior to start of intervention.

N/A

Outcomes

Critical

1. Symptoms of depression (measured continuously or dichotomously) or diagnosis of MDD (using a validated diagnostic interview)

2. Health-related quality of life (validated tool)

3. Suicidality (suicide ideation, plan, attempt, or completion)

4. Social function (e.g., partner, peer, work, and family relationships)

5. Impact on lifestyle behaviour (e.g., substance abuse)

Important

1. School performance

2. Lost time at work/school

3. False-positive result (i.e., positive screen in absence of depressive disorder), overdiagnosis, or overtreatment

4. Labelling

5. Harms of treatment

N/A

Setting

Primary care or non-mental health clinic settings, such as medical specialist clinics, schools or recreational/community settings, and online settings (e.g., online depression screening), where screening is administered by a health practitioner.

Studies conducted in mental health, or psychiatric settings. Studies in non-mental health clinic settings where screening is administered by a non-health practitioner.

Study design

Randomized controlled trials (RCTs), including cluster-randomized trials.^a

If no or only a single RCT is available, then controlled studies without random assignment.^b

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

Interrupted times series, single cohort studies, case-control studies, cross-sectional studies, case series, case reports, and other publication types (editorials, commentaries, notes, letter, opinions).

Publication language

English or French.

Languages other than English and French.

Dates of publication

January 2017 to February 2021 (RCTs).

January 2015 to February 2021 (non-RCTs).