• Ian B Hickie, Tracey A Davenport, and Cristina S Ricci.
• beyondblue: the national depression initiative, PO Box 6100, Hawthorn, West, VIC 3122, Australia. ian.hickie@beyondblue.org.au
• Med. J. Aust. 2002 Oct 7; 177 (S7): S111-6.

ObjectiveTo determine if screening in general practice and related medical settings improves management and clinical outcomes in people with depression.Data SourcesThe Medline (1966-2002), EMBASE (1980-2002) and PsycINFO (1966-2002) databases were searched. These were supplemented by searching the Cochrane databases (to 2002); performing additional specific searches on Medline, EMBASE and PsycINFO; scrutinising reference lists of selected articles; and querying experts.Study SelectionInclusion criteria were: review of prospective studies with a primary focus of depression screening in general practice settings; review of studies of healthy populations or people with known depression; publication in a peer-reviewed journal; and written in English. Eleven reviews that satisfied these criteria were assessed for quality using the Oxman and Guyatt Index. Four reviews met the criterion of a score of five or more.Data ExtractionOne author tabulated relevant material (including number and type of studies, outcomes/endpoints, measures of association/statistical results, and findings) from the four key reviews. A second author independently checked the accuracy of this extracted material.Data SynthesisBrief self-report instruments have acceptable psychometric properties and are practical for use in general practice settings. Screening increases the recognition and diagnosis of depression and, when integrated with a commitment to provide coordinated and prompt follow-up of diagnosis and treatment, clinical outcomes are improved.ConclusionsAlthough controversial, the evidence is now in favour of the appropriate use of screening tools in primary care.

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