Does Evidence Support the American Heart Association’s Recommendation to Screen Patients for Depression in Cardiovascular Care? An Updated Systematic Review

Objectives: To systematically review evidence on depression screening in coronary heart disease (CHD) by assessing the (1) accuracy of screening tools; (2) effectiveness of treatment; and (3) effect of screening on depression outcomes. Background: A 2008 American Heart Association (AHA) Science Advisory recommended routine depression screening in CHD. Methods: CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases searched through December 2, 2011; manual journal searches; reference lists; citation tracking; trial registries. Included articles (1) compared a depression screening instrument to a depression diagnosis; (2) compared depression treatment to placebo or usual care in a randomized controlled trial (RCT); or (3) assessed the effect of screening on depression outcomes in a RCT. Results: There were few examples of screening tools with good sensitivity and specificity using a priori-defined cutoffs i