for the Depression Screening Data (DEPRESSD) PHQ Collaboration IMPORTANCE The Patient Health Questionnaire depression module (PHQ-9) is a 9-item self-administered instrument used for detecting depression and assessing severity of depression. The Patient Health Questionnaire-2 (PHQ-2) consists of the first 2 items of the PHQ-9 (which assess the frequency of depressed mood and anhedonia) and can be used as a first step to identify patients for evaluation with the full PHQ-9.OBJECTIVE To estimate PHQ-2 accuracy alone and combined with the PHQ-9 for detecting major depression.

Objective To provide an estimate of the effect of interventions on comorbid depressive disorder (MDD) or subthreshold depression in type 1 and type 2 diabetes. Methods Systematic review and meta‐analysis. We searched PubMed, PsycINFO, Embase, and the Cochrane Library for randomized controlled trials evaluating the outcome of depression treatments in diabetes and comorbid MDD or subthreshold symptoms published before August 2019 compared to care as usual (CAU), placebo, waiting list (WL), or active comparator treatment as in a comparative effectiveness trial (CET). Primary outcomes were depressive symptom severity and glycemic control. Cohen's d is reported. Results Forty‐three randomized controlled trials (RCTs) were selected, and 32 RCTs comprising 3,543 patients were included in the meta‐analysis. Our meta‐analysis showed that, compared to CAU, placebo or WL, all interventions showed a significant effect on combined outcome 0,485 (95% CI 0.360; 0.609). All interventions showed a significant effect on depression. Pharmacological treatment, group therapy, psychotherapy, and collaborative care had a significant effect on glycemic control. High baseline depression score was associated with a greater reduction in HbA1c and depressive outcome. High baseline HbA1c was associated with a greater reduction in HbA1c. Conclusion All treatments are effective for comorbid depression in type 1 diabetes and type 2 diabetes. Over the last decade, new interventions with large effect sizes have been introduced, such as group‐based therapy, online treatment, and exercise. Although all interventions were effective for depression, not all treatments were effective for glycemic control. Effective interventions in comorbid depressive disorder may not be as effective in comorbid subthreshold depression. Baseline depression and HbA1c scores modify the treatment effect. Based on the findings, we provide guidance for treatment depending on patient profile and desired outcome, and discuss possible avenues for further research.

Overt hypothyroidism [raised serum thyroid-stimulating hormone (TSH) associated with low serum-free thyroxine (FT4)] and subclinical hypothyroidism (raised TSH with normal serum FT4) affect 2%-10% of the population. 1 Autoimmunity is the cause of hypothyroidism in about 80% of cases. 1 While in most patients treatment with levothyroxine (L-T4) restores health, 10%-15% of patients do not regain their well-being after apparently adequate treatment with L-T4. [2][3][4] Persistent symptoms are non-specific and include fatigue, weight gain and mood changes. 1,5 Such symptoms may lead to multiple medical consultations, patient requests for inappropriate investigations and dissatisfaction with treatment. [5][6][7] Given the high prevalence of hypothyroidism, this loss of wellbeing in a significant fraction of patients causes considerable socio-economic burden 8 and clinical management can be difficult and frustrating both for patients and for clinicians. 7 The underlying causes for persistent symptoms are unclear. Here, we outline |