SADS in Children - KQ2
Screening for Anxiety Depression and Suicide Risk in Children and Adolescents - KQ2 Diagnostic Accuracy
Background: Mental health conditions in children and adolescents may present as physical symptoms and may occur concurrently, presenting primary care physicians with opportunities to screen for one or more conditions.
Purpose: To review the evidence on screening (benefits and harms of screening, accuracy of screening, benefits and harms of treatment) for suicide risk, anxiety, and depression in children and adolescents in settings relevant to primary care in the United States for the U.S. Preventive Services Task Force.
Data Sources: PubMed, the Cochrane Library, PsycINFO, CINAHL and trial registries through July 19, 2021; bibliographies from retrieved articles, outside experts, and surveillance of the literature through June 1, 2022.
Study Selection: Two investigators independently selected English-language studies using a priori defined criteria. We included trials that evaluated the benefits or harms of screening for suicide risk, anxiety, or depression compared with no screening or usual care. We included studies of screening with instruments feasible in primary care settings. For treatment benefits and harms, we included drugs approved for pediatric use by the Food and Drug Administration. For suicide and depression treatment studies, we included any eligible psychotherapy or collaborative care interventions. For anxiety, we restricted nonpharmacological interventions to cognitive behavioral therapy (CBT). Eligible outcomes included test accuracy, symptoms, response, remission, loss of diagnosis, all-cause mortality, functioning, suicide-related symptoms or events, withdrawal due to adverse events, serious adverse events, and harms from screening. We also included systematic reviews reporting on harms of treatment. We excluded studies with poor methodological quality.
Data Extraction: One investigator extracted data and a second checked accuracy. Two reviewers independently rated methodological quality for all included studies. When at least three similar studies were available, we conducted meta-analyses.
Link to full report: https://www.ncbi.nlm.nih.gov/books/NBK585407/
- Funding Source
AHRQ Contract No. HHSA-290-2015-00011-I, Task Order No. 15