Depression screening and patient outcomes in cancer: A systematic review

Anna Meijer, Michelle Roseman, Katherine Milette, James C. Coyne, Michael Edward Stefanek, Roy C. Ziegelstein, Erin Arthurs, Allison Leavens, Steven C. Palmer, Donna E. Stewart, Peter de Jonge, Brett D. Thombs

Research output: Contribution to journalReview article

46 Citations (Scopus)

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.

Original languageEnglish (US)
Article numbere27181
JournalPloS one
Volume6
Issue number11
DOIs
StatePublished - Nov 14 2011

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systematic review
Screening
Depression
screening
neoplasms
Neoplasms
Early Detection of Cancer
Randomized Controlled Trials
signs and symptoms (animals and humans)
Major Depressive Disorder
nurses
physicians
placebos
Information Storage and Retrieval

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

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), [e27181]. https://doi.org/10.1371/journal.pone.0027181

Depression screening and patient outcomes in cancer : A systematic review. / Meijer, Anna; Roseman, Michelle; Milette, Katherine; Coyne, James C.; Stefanek, Michael Edward; Ziegelstein, Roy C.; Arthurs, Erin; Leavens, Allison; Palmer, Steven C.; Stewart, Donna E.; de Jonge, Peter; Thombs, Brett D.

In: PloS one, Vol. 6, No. 11, e27181, 14.11.2011.

Research output: Contribution to journalReview article

Meijer, A, Roseman, M, Milette, K, Coyne, JC, Stefanek, ME, Ziegelstein, RC, Arthurs, E, Leavens, A, Palmer, SC, Stewart, DE, de Jonge, P & Thombs, BD 2011, 'Depression screening and patient outcomes in cancer: A systematic review', PloS one, vol. 6, no. 11, e27181. https://doi.org/10.1371/journal.pone.0027181
Meijer A, Roseman M, Milette K, Coyne JC, Stefanek ME, Ziegelstein RC et al. Depression screening and patient outcomes in cancer: A systematic review. PloS one. 2011 Nov 14;6(11). e27181. https://doi.org/10.1371/journal.pone.0027181
Meijer, Anna ; Roseman, Michelle ; Milette, Katherine ; Coyne, James C. ; Stefanek, Michael Edward ; Ziegelstein, Roy C. ; Arthurs, Erin ; Leavens, Allison ; Palmer, Steven C. ; Stewart, Donna E. ; de Jonge, Peter ; Thombs, Brett D. / Depression screening and patient outcomes in cancer : A systematic review. In: PloS one. 2011 ; Vol. 6, No. 11.
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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.

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