Letters

Questionnaires for depression and anxiety

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7305.167/b (Published 21 July 2001) Cite this as: BMJ 2001;323:167

Systematic review is incomplete

  1. Michael Pignone (pignone@med.unc.edu), assistant professor of medicine,
  2. Bradley N Gaynes, assistant professor of psychiatry,
  3. Kathleen N Lohr, professor of health policy and administration,
  4. C Tracy Orleans, senior scientist,
  5. Cynthia Mulrow, professor of medicine
  1. University of North Carolina, Chapel Hill, NC 27599-7110, USA
  2. Robert Wood Jones Foundation, Princeton, NJ 08543, USA
  3. University of Texas Health Science Center-San Antonio, San Antonio, TX 78284, USA
  4. University of Pennsylvania, Comprehensive Cancer Center, 3400 Spruce Street/11 Gates, Philadelphia, PA 19104, USA
  5. University of Auckland, Private Bag 92019, Auckland, New Zealand

    EDITOR—Gilbody et al published a systematic review of the effect in primary care settings of routinely administered questionnaires on the recognition, treatment, and outcome of psychiatric disorders, particularly depression.1 They reviewed randomised trials published throughout 2000 and concluded that the routine administration of such questionnaires is a costly exercise that has not been shown to influence clinicians' behaviour.

    On behalf of the United States Preventive Services Task Force, we performed a broader systematic review of the effectiveness of routine screening for depression. In addition to those reported in Gilbody et al, we identified six randomised trials of screening that examined recognition, treatment, or clinical outcomes.27 Each study used a validated screening instrument and gave feedback to providers of the screening results; some also confirmed results from the screening instrument with a criterion standard or gave systematic support to providers and patients to improve the quality of care after recognition of the diagnosis or condition. Gilbody et al cited the study by Wells et al in their discussion but did not include it in their analysis; other studies were not addressed in the report. Since several of these studies had positive impact on at least one major outcome, we are concerned that not including them may have affected the conclusions of the review. Gilbody et al included one study of depression …

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