Ability of nurses to identify depression in primary care, secondary care and nursing homes—A meta-analysis of routine clinical accuracy

PurposeTo clarify the ability of nurses and nursing assistants working in primary care, secondary care and nursing homes to identify depressed individuals using their clinical skills using meta-analysis of published studies.MethodsLiterature search, appraisal and meta-analysis. We located 22 studies reporting on the detection of depression, 4 involving primary care or community nurses; 7 involving hospital nurses and 11 from nursing homes.17 of 22 studies had specificity data.ResultsAcross all 22 studies involving 7061 individuals, and a prevalence of 28.1% (95% CI = 22.6–33.9%), practice and community nurses correctly identified 26.3% (95% CI = 16.2–37.8%) of people with depression. They also correctly identified 94.8% (95% CI = 91.3–97.4%) of the non-depressed. Nurses working in hospital settings correctly identified 43.1% (95% CI = 31.9–54.8%) of people with depression and 79.6% (95% CI = 71.5–86.7%) of the non-depressed. Those working in nursing homes correctly identified 45.8% (95% CI = 38.1–53.6%) of people with depression and 80.0% (95% CI = 68.6–88.7%) of the non-depressed.ConclusionsNurses have considerable difficulty accurately identifying depression but are probably at least as accurate as medical staff.