The performance and accuracy of depression screening tools capable of self-administration in primary care: A systematic review and meta-analysis

• Peter Miller ^[2] ; David Newby ^[3] ; Emily Walkom ^[4] ; Jenny Schneider ^[5] ; Shu Chuen Li ^[2] ; Tiffany-Jane Evans ^[1]
  1. [1] Hunter Medical Research Institute

     Hunter Medical Research Institute

     Australia

     
  2. [2] Pharmacy and Experimental Pharmacology, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle. Australia
  3. [3] Pharmacy and Experimental Pharmacology, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle
  4. [4] School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle. Australia
  5. [5] School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, The Hunter Medical Research Institute (HMRI). Australia

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 35, Nº 1, 2021, págs. 1-18
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2020.10.002
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• Resumen

  • Background and Objectives The US Preventative Services Taskforce recommends screening adults for depression in primary care where adequate systems are established to ensure accurate diagnosis, effective treatment and follow-up. However, there is currently no consensus on which screening tool is most suitable for use in primary healthcare. We aim to systematically review the literature for operating characteristics of depression screening tools capable of self-administration in primary healthcare and meta-analyse the psychometric characteristics of these tools to determine their performance and accuracy.

    Methods An electronic literature search of EMBASE, Medline and CINAHL Complete was conducted from January 1982 to September 15, 2019 using the keywords: depression, screening, primary healthcare and adult. General and psychometric characteristics were extracted for screening tools studied in primary healthcare only when assessed against a ‘reference-standard’.

    Results Eighty-one studies from 22 countries were included in the review. Forty unique depression screening tools suitable for self-administration were identified in studies yielding 138 psychometric data sets. Based on ease of administration, 18 screening tools were suitable for use in primary healthcare. Of the tools meta-analysed, only the PHQ-9 and WHO-5 displayed superior accuracy and were easily administered.

    Conclusion Although numerous depression screening tools are suitable for use in primary care based on ease of administration, the PHQ-9 was the most widely assessed tool and displayed superior DOR, a-ROC, specificity and LR + . Our review supports the use of the PHQ-9 as a brief, easily administered depression screening tool with superior discriminatory performance and robust psychometric characteristics in primary care settings.