Recommendation on screening adults for depression using a screening tool.

BACKGROUND: Depression negatively affects how a person feels, thinks, or behaves; is associated with impaired functioning in social and work settings; and can be associated with thoughts of suicide. This update of the 2013 Canadian Task Force on Preventive Health Care guideline provides an evidence-based recommendation about instrument-based screening for depression. METHODS: For this update, we commissioned a systematic review on benefits and harms of instrument-based screening (i.e., using a screening tool) for depression among adults. The systematic review covered relevant literature from October 2018 to May 2020, updated to January 2025 for trials, and to March 2025 for trial registries. We examined patient values and preferences via patient engagement surveys and focus groups; we engaged content experts and other interest holders at key points throughout the project. We used the Grading of Recommendations, Assessment, Development and Evaluation approach to determine the certainty of evidence for each outcome and strength of the recommendation; adhered to the Guidelines International Network principles of managing competing interests; and followed Appraisal of Guidelines for Research and Evaluation, and Guidance for Reporting Involvement of Patients and the Public reporting guidance. RECOMMENDATIONS: We recommend against screening all adults aged 18 years and older for depression using questionnaires (strong recommendation, very low-certainty evidence), based on evidence suggesting that depression screening using a screening tool has little to no effect on health. This recommendation does not apply to adults with a personal history, current diagnosis, or clinical suspicion of a diagnosis of depression or another mental health disorder. It does apply to those who may be at an elevated risk of depression. INTERPRETATION: The recommendation against screening adults for depression using a screening tool emphasizes the importance of good clinical care, where clinicians ask about their patients' well-being and remain vigilant for symptoms and signs of depression.