Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force
Abstract
BACKGROUND: Major depressive disorder (MDD) is common among children and adolescents and is associated with functional impairment and suicide. PURPOSE: To update the 2009 U.S. Preventive Services Task Force (USPSTF) systematic review on screening for and treatment of MDD in children and adolescents in primary care settings. DATA SOURCES: Several electronic searches (May 2007 to February 2015) and searches of reference lists of published literature. STUDY SELECTION: Trials and recent systematic reviews of treatment, test-retest studies of screening, and trials and large cohort studies for harms. DATA EXTRACTION: Data were abstracted by 1 investigator and checked by another; 2 investigators independently assessed study quality. DATA SYNTHESIS: Limited evidence from 5 studies showed that such tools as the Beck Depression Inventory and Patient Health Questionnaire for Adolescents had reasonable accuracy for identifying MDD among adolescents in primary care settings. Six trials evaluated treatment. Several individual fair- and good-quality studies of fluoxetine, combined fluoxetine and cognitive behavioral therapy, escitalopram, and collaborative care demonstrated benefits of treatment among adolescents, with no associated harms. LIMITATION: The review included only English-language studies, narrow inclusion criteria focused only on MDD, high thresholds for quality, potential publication bias, limited data on harms, and sparse evidence on long-term outcomes of screening and treatment among children younger than 12 years. CONCLUSION: No evidence was found of a direct link between screening children and adolescents for MDD in primary care or similar settings and depression or other health-related outcomes. Evidence showed that some screening tools are accurate and some treatments are beneficial among adolescents (but not younger children), with no evidence of associated harms. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
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Prior to the pandemic, fewer than 50% of adolescents with depression used adequate services.
“Prior to the pandemic, fewer than 50% of adolescents with depression used adequate services [23,24].”
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- Authors
- Forman-Hoffman, V., McClure, E., McKeeman, J., Wood, C. T., Middleton, J. C., Skinner, A. C., Perrin, E. M., & Viswanathan, M.
- Affiliations
- From RTI International, Research Triangle Park, and University of North Carolina, Chapel Hill, North Carolina.
- University of North Carolina at Chapel Hill (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2016-03-01
- Volume
- 164
- Issue
- 5
- Pages
- 342-349
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2292822962
- Cited by
- 93
- References
- 45
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 8 · 2023: 12 · 2022: 7 · 2021: 16 · 2020: 2 · 2019: 12 · 2018: 15 · 2017: 7 · 2016: 5 · 2014: 1
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- major depressive disorder, depression screening, children, adolescents, primary care, screening accuracy, Beck Depression Inventory, PHQ-A, fluoxetine, cognitive behavioral therapy, escitalopram, collaborative care, depression treatment, screening harms
- MeSH terms
- Adolescent, Child, Major Depressive Disorder, Humans, Mass Screening, Primary Health Care, Suicide, United States
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