U.S. Preventive Services Task Force recommends screening of depression for all adults

The new recommendations by the U.S. Preventive Services Task Force (USPSTF) encourage primary care physicians to initiate depression screening for all adult patients at least once, regardless of their risk factors.

These recommendations have been updated from those in 2009, in two significant ways:

• The panel suggested screening for everyone of age 18 and older at all clinics.

• Screening of pregnant women or those who recently gave birth, previously excluded from earlier recommendations, was stressed upon.

“These recommendations are taking something that is good and making it even better,” said Dr. Michael E. Thase, professor of psychiatry at University of Pennsylvania. “They no longer say ‘when support is available’ because they just assume that it’s available. The care for depression in primary care settings is improving.”

The importance of early screening

The USPSTF gathered credible evidence considering the importance of early screening. The evidence showed that:

• Depression constitutes a leading cause of disability in people of age 15 and older, and is commonly seen in patients in the primary care setting.

• Screening yields accurate identification of adults in primary care settings.

• The combination of depression screening with adequate support systems improved clinical outcomes.

• Screening in primary care settings with antidepressants, psychotherapy or both significantly decrease clinical morbidity.

• The disadvantages from screening of depression in adults is small to none.

Screening for depression

Many primary care doctors are likely to already be screening patients for depression, and current recommendations are expected to propel screenings further. Certain electronic medical systems require doctors to state having screened a patient before they can complete the appointment.

Screenings are typically conducted through the completion of a test by the patient, either on paper or electronically, while waiting to see the doctor. If the test discloses a risk of depression, a more thorough evaluation and detailed communication about treatment with the patient are conducted.

Research projects the nine-question test called the Patient Health Questionnaire to be a reliable indicator for identifying individuals at risk of having depression. Moving beyond mood, fatigue and concentration, the test also involves questions regarding appetite, interest in activities and thoughts of self-harm.

A seven-question test has also been recommended as an alternative for screening. Older adults and women during the perinatal period may need to be screened with variations of these tests.

Loopholes

Even though the efficacy of these tests is supported by substantial evidence, they do have certain shortcomings:

• If patients intend to keep their depression hidden, they can easily judge what the tests are for and deliberately give incorrect answers.

• Another flaw is the identification of individuals who have other disorders such as alcoholism or obsessive compulsive disorder. The nine-question test, in such a case, is likely to pick at least 50 percent of patients who are battling another issue than depression.

Major depressive disorder is one of the leading public health problems in the world, but the increasing availability of effective treatments is helping to combat the disorder’s high mortality and morbidity. Hence, the importance of ensuring efficient methods for population screening cannot be stressed enough.

Sovereign Health is a leading behavioral health treatment provider, devoted to evidence-based treatment for substance abuse disorder and mental illness. Our clinicians take an all-inclusive and holistic approach to ensure a real and sustained recovery. If you or a loved one is currently struggling to regain control of your life, call us right away.

About the author

Sana Ahmed is a staff writer for Sovereign Health Group. A journalist and social media savvy content developer with extensive research, print and on-air interview skills, Sana has previously worked as an editor for a business magazine and been an on-air news broadcaster. She writes to share the amazing developments from the mental health world and unsuccessfully attempts to diagnose her friends and family. For more information and other inquiries about this article, contact the author at news@sovhealth.com.