Abstract
BackgroundMajor depressive disorder is common, debilitating, and affects feelings, thoughts, mood, and behaviors. Childhood and adolescence are critical periods for the development of depression and adolescence is marked by an increased incidence of mental health disorders. This protocol outlines the planned scope and methods for a systematic review update that will evaluate the benefits and harms of screening for depression in children and adolescents.MethodsThis review will update a previously published systematic review by Roseman and colleagues. Eligible studies are randomized controlled trials (RCTs) assessing formal screening in primary care to identify children or adolescents not already self-reporting symptoms of, diagnosed with, or treated for depression. If no or only a single RCT is available, we will consider controlled studies without random assignment. Studies of participants with characteristics associated with an elevated risk of depression will be analyzed separately. Outcomes of interest are symptoms of depression, classification of major depressive disorder based on a validated diagnostic interview, suicidality, health-related quality of life, social function, impact on lifestyle behavior (e.g., substance use, school performance, lost time at work, or school), false-positive results, overdiagnosis, overtreatment, labeling, and other harms such as those arising from treatment. We will search MEDLINE, Embase, PsycINFO, CINAHL, the Cochrane Library, and grey literature sources. Two reviewers will independently screen the titles and abstracts using the liberal accelerated method. Full-text screening will be performed independently by two reviewers using pre-specified eligibility criteria. Data extraction and risk of bias assessments will be performed independently by two reviewers. Pre-planned analyses, including subgroup and sensitivity analyses, are detailed within this protocol. Two independent reviewers will assess and finalize through consensus the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and prepare GRADE evidence profiles and summary of findings tables for each outcome of interest.DiscussionThe systematic review will provide a current state of the evidence of benefits and harms of depression screening in children and adolescents. These findings will be used by the Canadian Task Force on Preventive Health Care to inform the development of recommendations on depression screening.Systematic review registrationPROSPERO CRD42020150373
Highlights
Major depressive disorder is common, debilitating, and affects feelings, thoughts, mood, and behaviors
The systematic review will provide a current state of the evidence of benefits and harms of depression screening in children and adolescents
These findings will be used by the Canadian Task Force on Preventive Health Care to inform the development of recommendations on depression screening
Summary
Studies in primary care or non-mental health clinic settings (e.g., medical specialist clinics, schools, or recreational/community settings) and online settings where screening is administered by a health practitioner will be eligible Since this is a review update from Roseman et al [51], we will continue to limit to RCTs and include reports from January 2017 onwards. Intervention Screening tools that use a single question, a small set of Screening tools that, in addition to screening, include depression questions, or a screening questionnaire (validated or noncare referral or treatment options not available to patients validated) with a pre-defined cut-off score to identify patients who identified as depressed in the non-screening trial arm 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. Schools or recreational/community settings, and in non-mental health clinic settings where screening is adminisonline settings (e.g., online depression screening), where screening tered by a non-health practitioner. is administered by a health practitioner
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