Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression.

To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event.

MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles.

English-language studies of post-ACS patients that evaluated the diagnostic accuracy of depression screening tools or compared the safety and effectiveness of a broad range of pharmacologic and nonpharmacologic depression treatments.

2 investigators independently screened each article for inclusion; abstracted the data; and rated the quality, applicability, and strength of evidence.

Evidence from 6 of the 10 included studies showed that a range of depression screening instruments produces acceptable levels of diagnostic sensitivity, specificity, and negative predictive values (70% to 100%) but low positive predictive values (below 50%). The Beck Depression Inventory-II was the most studied tool. A large study found that a combination of cognitive behavioral therapy (CBT) and antidepressant medication improved depression symptoms, mental health–related function, and overall life satisfaction more than usual care.

Few studies, no evaluation of the influence of screening on clinical outcomes, and no studies addressing several clinical interventions of interest.

Depression screening instruments produce diagnostic accuracy metrics that are similar in post-ACS patients and other clinical populations. Depression interventions have an uncertain effect on cardiovascular outcomes, but CBT combined with antidepressant medication produces modest improvement in psychosocial outcomes.

Agency for Healthcare Research and Quality (PROSPERO: CRD42016047032).

患有急性冠状动脉综合征 (ACS) 事件的患者患抑郁症的风险增加。

评估抑郁症筛查工具的诊断准确性，并比较 ACS 事件发生后 3 个月内成人抑郁症治疗的安全性和有效性。

2003 年 1 月至 2017 年 8 月的 MEDLINE、EMBASE、PsycINFO、CINAHL 和 Cochrane 系统评价数据库，以及手动搜索关键主要和评论文章的引文。

对 ACS 后患者的英语研究，评估抑郁症筛查工具的诊断准确性或比较广泛的药物和非药物抑郁症治疗的安全性和有效性。

2名研究者独立筛选每篇文章以纳入；提取数据；并对证据的质量、适用性和强度进行评级。

纳入的 10 项研究中有 6 项的证据表明，一系列抑郁症筛查工具的诊断敏感性、特异性和阴性预测值（70% 至 100%）的可接受水平，但阳性预测值较低（低于 50%）。贝克抑郁量表-II 是研究最多的工具。一项大型研究发现，认知行为疗法 (CBT) 和抗抑郁药物的组合比常规护理更能改善抑郁症状、心理健康相关功能和整体生活满意度。

很少有研究，没有评估筛查对临床结果的影响，也没有研究涉及几种感兴趣的临床干预措施。

抑郁症筛查仪器产生的诊断准确性指标在 ACS 后患者和其他临床人群中相似。抑郁症干预对心血管结局的影响不确定，但 CBT 联合抗抑郁药物对社会心理结局产生了适度的改善。

医疗保健研究和质量机构 (PROSPERO: CRD42016047032)。