Four cross-sectional studies (1,359 participants, range 116 to 580) were included in the review. All studies assessed self-administered questionnaires and were conducted in USA or Australia. Quality scores ranged from 4 to 6 out of a maximum of 6. Three out of four studies failed the question: "the results of the test of interest could not have been influenced by the results of the reference standard?"
All four studies assessed brief screening questions for depression. Questions assessed were similar in three of the four studies (such as "feeling down or depressed?" and "little interest or pleasure in doing things?"). The fourth study asked if participants characterised themselves as depressed. Each study used a different reference standard. The sensitivity of brief screening questions ranged from 50.5% to 82.1%, specificity ranged from 77.0% to 90.6% and overall accuracy ranged from 74.6% to 80.6%.
Two studies (n=547) assessed brief screening questions for anxiety. Each study assessed different screening questions and used a different reference standard. For the question "do you characterise yourself as anxious or tense?", the reported sensitivity for trait anxiety was 63.0%, specificity was 71.2% and overall accuracy was 68.1%; results were similar for state anxiety. The second study asked about feeling anxious, worrying about lots of different things and anxiety attacks in the preceding month and reported sensitivity of 94%, specificity of 53% and overall accuracy of 60%.
No studies assessed the diagnostic accuracy of brief screening questions for fear-avoidance beliefs, social isolation, catastrophization or somatization.