Background

Web-based depression screenings are commonly used, often providing automated feedback to users. However, there are concerns about potential negative effects, and clear evidence is lacking.

Objective

The goal of this study was to investigate if automated feedback after screening could lead to:

Misdiagnosis
Mistreatment
Worsening depression
Negative emotional responses
Increased suicidal thoughts

Methods

This analysis was part of a larger study called the DISCOVER trial, which involved individuals who screened positive for depression but had not yet been diagnosed. Participants were divided into three groups:

No feedback
Nontailored feedback
Tailored feedback

We compared the outcomes of these groups over time.

Results

Among 948 participants, we found:

Misdiagnosis rates were low and similar across all groups (3.5% to 4.9%).
Mistreatment rates were also consistent (7.2% to 8.3%).
Worsening depression was minimal (2% to 6.8%).
Emotional responses did not significantly change (0.7% to 2.9%).
However, there was a notable increase in suicidal thoughts in the nontailored feedback group at one month (12.3% vs 6.4% in no feedback).

Conclusions

The study suggests that automated feedback after web-based depression screening does not lead to significant negative outcomes like misdiagnosis or worsening depression. However, nontailored feedback may increase suicidal thoughts, highlighting the need for cautious implementation.