First author, year, country | Included in 2009 USPSTF, Cochrane, or both reviews or updated search | Number of patients randomized | Eligibility and randomization | Determined eligibility and randomized of patients analyzed prior to screening? | Diagnostic/treatment status | Excluded already diagnosed and already treated patients? | Depression management | Similar depression management options for screened and unscreened trial arms? |
---|---|---|---|---|---|---|---|---|
Callahan 1994, US [19] | Both | 175 | Patients with CES-D ≥ 16 and HAMD ≥ 15 eligible and randomized to enhanced depression care versus usual care. | No | 21% of enrolled patients already diagnosed and 12% already on antidepressant (overlap not specified). | No | Intervention arm: enhanced depression care. | No |
Control arm: usual care. | ||||||||
Cochrane + 2002 USPSTFa | 116 | Patients with BDI ≥14 eligible and randomized to have their BDI scores and diagnostic interpretation disclosed to their physician or not disclosed. | No | Patients excluded if their physicians believed they were currently depressed, but already diagnosed and already treated patients not necessarily excluded.b | No | Both groups received usual care. | Yes | |
Lewis 1996, UK [24] | Cochrane + 2002 USPSTFc | 454d | Patients with GHQ-12 ≥2 eligible and randomized to have their GHQ-12 scores placed in their physician’s notes or not disclosed. | No | Existing depression diagnosis or treatment not in exclusion criteria. No information on depression diagnosis or treatment at time of enrollment provided. | No | Both groups received usual care. | Yes |
Williams 1999, US [20] | Both | 969e | Patients randomized to screening with single mood question, with the CES-D, or to usual care. Depression outcomes only assessed for 97 patients with major depression at baseline and a sample of 119 other patients. | Yese | Only 11 of 41 diagnoses of depression post-screening were new diagnoses (27%). Patients classified as new diagnoses if no evidence of diagnosis in chart and patient reported that not diagnosed or treated in last 2Â years.f | No | Both groups received usual care. | Yes |
USPSTF | 1356 | Patients with probable depressive disorder eligible and randomized to enhanced depression care versus usual care. | No | In 6Â months prior to trial, 48% of patients discussed emotional issues at medical visit; 29% had specialty mental health visit; 44% getting appropriate mental health care. | No | Intervention arm: enhanced depression care. | No | |
Control arm: usual care. | ||||||||
Whooley 2000, US [21] | Both | 2346g | Patients randomized to screening with GDS and seven educational sessions versus usual care. Only 331 patients with GDS ≥6 at baseline included in depression outcome analysis. | Yesg | In 12 months prior to trial, 20% of patients in outcome analysis prescribed antidepressant medication. | No | Intervention arm: patients offered six weekly educational sessions on depression plus one booster session. | No |
Control arm: usual care. | ||||||||
USPSTF | 479 | Patients with five or more symptoms of current MDD eligible. Practices randomized to enhanced depression care versus usual care. | No | In 6Â months prior to trial, 44% of patients were prescribed antidepressant medication or had a specialty mental health care visit. | No | Intervention arm: enhanced depression care. | No | |
Control arm: usual care. | ||||||||
Jarjoura 2004, US [16] | USPSTF | 61 | Patients positive for depression on PRIME-MD eligible and randomized to nurse-supported depression management and referral program versus usual care. | No | Patients receiving intervention for mental health problems or seeking help for depression or other emotional problems excluded. | Yes | Intervention arm: nurse-supported depression management and referral program. | No |
Control arm: usual care. | ||||||||
Bergus 2005, US [22] | Both | 51 | Patients with low mood or anhedonia in last two weeks based on PHQ-9 eligible and randomized to have their PHQ-9 scores disclosed to their physician or not disclosed. | No | 38% of enrolled patients on medication for depression or anxiety at time of enrollment and 60% had history of depression treatment. | No | Both groups received usual care. | Yes |
Bosmans 2006, The Netherlands [17] | USPSTF | 145 | Patients with GDS ≥5 and positive for depression on PRIME-MD eligible and randomized to enhanced depression care versus usual care. | No | Patients using antidepressants at time of trial enrollment excluded. | Yesh | Intervention arm: enhanced depression care. | No |
Control arm: usual care. | ||||||||
Rubenstein 2007, US [18] | USPSTF | 792 | Patients were randomized to practices in a Veterans Administration healthcare system that provided enhanced geriatric care versus usual care. Patients positive on ≥4 of 10 GPSS items related to falls/balance, urinary incontinence, depression, memory loss, pain, weight loss, polypharmacy and general health were eligible.i | Nog | Existing depression diagnosis or treatment not in exclusion criteria. No information on depression diagnosis or treatment at time of enrollment provided. | No | Intervention arm: enhanced geriatric care. | No |
Control arm: usual care. | ||||||||
Yeung 2010, US [30] | Updated Search | 100 | Patients with confirmed MDD randomized to enhanced depression care versus usual care. | No | Patients already receiving treatment for MDD were excluded. | Yes | Intervention arm: enhanced depression care. | No |
Control arm: usual care. | ||||||||
Yawn 2012, US [31] | Updated Search | 2343j | Primary care practices were randomized to a complex depression care intervention, including screening with EPSD and PHQ-9, versus usual care. Women 5 to 12Â weeks postpartum were eligible. Only 408 patients with positive depression screen at baseline included in depression outcome analysis. | Yesj | Existing depression diagnosis or treatment not in exclusion criteria. No information on depression diagnosis or treatment at time of enrollment provided. | No | Intervention arm: enhanced depression care. | No |
Control arm: usual care. | ||||||||
Romera 2013, Spain [32] | Updated Search | 3737 | Primary care physician practices were randomized to training on screening with 2 questions and usual depression care versus usual care. After 6Â months, 3737 patients randomly selected for depression assessment. | Yes | Existing depression diagnosis or treatment not in exclusion criteria. No information on depression diagnosis or treatment at time of enrollment provided. | No | Both groups received usual care. | Yes |