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Depression screening and patient outcomes in cancer: a systematic review.
PLoS One 2011; 6(11):e27181Plos

Abstract

BACKGROUND

Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer patients by assessing the (1) accuracy of depression screening tools; (2) effectiveness of depression treatment; and (3) effect of depression screening, either alone or in the context of comprehensive depression care, on depression outcomes.

METHODS

Data sources were CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases through January 24, 2011; manual journal searches; reference lists; citation tracking; trial registry reviews. Articles on cancer patients were included if they (1) compared a depression screening instrument to a valid criterion for major depressive disorder (MDD); (2) compared depression treatment with placebo or usual care in a randomized controlled trial (RCT); (3) assessed the effect of screening on depression outcomes in a RCT.

RESULTS

There were 19 studies of screening accuracy, 1 MDD treatment RCT, but no RCTs that investigated effects of screening on depression outcomes. Screening accuracy studies generally had small sample sizes (median = 17 depression cases) and used exploratory methods to set sample-specific cutoff scores that varied substantially across studies. A nurse-delivered intervention for MDD reduced depressive symptoms moderately (effect size = 0.37).

CONCLUSIONS

The one treatment study reviewed reported modest improvement in depressive symptoms, but no evidence was found on whether or not depression screening in cancer patients, either alone or in the context of optimal depression care, improves depression outcomes compared to usual care. Depression screening in cancer should be evaluated in a RCT in which all patients identified as depressed, either through screening or via physician recognition and referral in a control group, have access to comprehensive depression care.

Authors+Show Affiliations

Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

22110613

Citation

Meijer, Anna, et al. "Depression Screening and Patient Outcomes in Cancer: a Systematic Review." PloS One, vol. 6, no. 11, 2011, pp. e27181.
Meijer A, Roseman M, Milette K, et al. Depression screening and patient outcomes in cancer: a systematic review. PLoS ONE. 2011;6(11):e27181.
Meijer, A., Roseman, M., Milette, K., Coyne, J. C., Stefanek, M. E., Ziegelstein, R. C., ... Thombs, B. D. (2011). Depression screening and patient outcomes in cancer: a systematic review. PloS One, 6(11), pp. e27181. doi:10.1371/journal.pone.0027181.
Meijer A, et al. Depression Screening and Patient Outcomes in Cancer: a Systematic Review. PLoS ONE. 2011;6(11):e27181. PubMed PMID: 22110613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression screening and patient outcomes in cancer: a systematic review. AU - Meijer,Anna, AU - Roseman,Michelle, AU - Milette,Katherine, AU - Coyne,James C, AU - Stefanek,Michael E, AU - Ziegelstein,Roy C, AU - Arthurs,Erin, AU - Leavens,Allison, AU - Palmer,Steven C, AU - Stewart,Donna E, AU - de Jonge,Peter, AU - Thombs,Brett D, Y1 - 2011/11/14/ PY - 2011/06/20/received PY - 2011/10/12/accepted PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/3/27/medline SP - e27181 EP - e27181 JF - PloS one JO - PLoS ONE VL - 6 IS - 11 N2 - BACKGROUND: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer patients by assessing the (1) accuracy of depression screening tools; (2) effectiveness of depression treatment; and (3) effect of depression screening, either alone or in the context of comprehensive depression care, on depression outcomes. METHODS: Data sources were CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases through January 24, 2011; manual journal searches; reference lists; citation tracking; trial registry reviews. Articles on cancer patients were included if they (1) compared a depression screening instrument to a valid criterion for major depressive disorder (MDD); (2) compared depression treatment with placebo or usual care in a randomized controlled trial (RCT); (3) assessed the effect of screening on depression outcomes in a RCT. RESULTS: There were 19 studies of screening accuracy, 1 MDD treatment RCT, but no RCTs that investigated effects of screening on depression outcomes. Screening accuracy studies generally had small sample sizes (median = 17 depression cases) and used exploratory methods to set sample-specific cutoff scores that varied substantially across studies. A nurse-delivered intervention for MDD reduced depressive symptoms moderately (effect size = 0.37). CONCLUSIONS: The one treatment study reviewed reported modest improvement in depressive symptoms, but no evidence was found on whether or not depression screening in cancer patients, either alone or in the context of optimal depression care, improves depression outcomes compared to usual care. Depression screening in cancer should be evaluated in a RCT in which all patients identified as depressed, either through screening or via physician recognition and referral in a control group, have access to comprehensive depression care. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22110613/Depression_screening_and_patient_outcomes_in_cancer:_a_systematic_review_ L2 - http://dx.plos.org/10.1371/journal.pone.0027181 DB - PRIME DP - Unbound Medicine ER -