Performance of screening tools in detecting major depressive disorder among patients with coronary heart disease: a systematic review.
BACKGROUND
Eligible studies published before 31 Dec 2013 were identified from the following databases: Ovid Medline, EMBASE, PsycINFO, Scopus, Cochrane Library, CINAHL Plus, and Web of Science.


METHODS
Eligible studies published before 31, Dec 2013 were identified from the following databases: Ovid Medline, EMBASE, psycINFO, Scopus, Cochrane Library, CINAHL Plus, and Web of Science.


RESULTS
Eight studies aiming to identify MDD in CHD patients were included, and there were 10 self-reporting questionnaires (such as PHQ-2, PHQ-9, PHQ categorical algorithm, HADS-D, BDI, BDI-II, BDI-II-cog, CES-D, SCL-90, 2 simple yes/no items) and 1 observer rating scale (Ham-D). For MDD alone, the sensitivity and specificity of various screening tools at the validity and optimal cut-off point varied from 0.34 [0.19, 0.52] to 0.96 [0.78, 1.00] and 0.69 [0.65, 0.73] to 0.97 [0.93, 0.99]. Results showed PHQ-9 (≥10), BDI-II (³14 or ≥16), and HADS-D (≥5 or ≥4) were widely used for screening MDD in CHD patients.


CONCLUSIONS
There is no consensus on the optimal screening tool for MDD in CHD patients. When evaluating the performance of a screening tool, balancing the high sensitivity and negative predictive value (NPV) between specificity and positive predictive value (PPV) for screening or diagnostic purpose should be considered. After screening, further diagnosis, appropriate management, and necessary referral may also improve cardiovascular outcomes.
Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).
Yanping
Y
Ren
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
Hui
H
Yang
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
Colette
C
Browning
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
Shane
S
Thomas
Department of Cardiology, Affiliated Beijing Anzhen Hospital of Capital Medical University, Beijing, China (mainland).
Meiyan
M
Liu
D000368:Aged; D003327:Coronary Disease / Q000150:complications*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011785:Quality Assurance, Health Care