Setting the Stage for More Depression Screening

Depression screening recommendations expanded by US Preventive Services Task Force

(RxWiki News) Depression can strike at any age and may have serious effects. For that reason, the US Preventive Services Task Force (USPSTF) has issued new screening recommendations.

The USPSTF is a group of volunteer medical experts that periodically reviews patient care standards and issues guidelines for preventive care. The team's latest recommendation is that all adults should be screened for depression.

Albert L. Siu, MD, MSPH, of the Mount Sinai School of Medicine in New York, led this task force.

Depression is one of the top causes of disability in people older than 14. The condition affects not only the individual, but families, businesses and society at large. Postpartum and pregnant women often experience depression.

The USPSTF periodically reviews preventive care guidelines for a variety of diseases and conditions. The last depression screening guidelines were issued in 2009. Past guidelines did not specifically recommend screening for pregnant and postpartum women.

To develop the new recommendations, the task force reviewed research on depression screening and assessed available screening tools. The task force also looked at the benefits and harms of both screening and treatment.

The new guidelines noted that screening in primary care settings helps identify patients with depression. Screening plus support systems may improve patient outcomes, Dr. Siu and team assert. They said screening causes little to no harm.

Treatment with antidepressants, psychotherapy or both can help improve depression. Some drugs may cause complications or side effects, but the task force noted that, overall, these harms appear small.

The new recommendations did not suggest the best interval for screening. However, the task force said all patients should be screened at least once. Patients who may face a high depression risk — due to life events, history of depression or other factors — should be screened at the doctor's discretion.

Drugs may not be the best treatment choice for women who are pregnant or breastfeeding. Pregnant and breastfeeding women should receive counseling rather than medications because of potential harm to the fetus or child, Dr. Siu and team wrote.

In an editorial about these new guidelines, Michael E. Thase, MD, of the University of Pennsylvania in Philadelphia, wrote, “Until there are better methods to match patients with specific forms of treatment, the best hope ... for patients with depression may be to adapt care systems to respond more flexibly and decisively to key events that are associated with non-adherence or treatment failure."

The new guidelines and editorial were published Jan. 26 in JAMA.

The Agency for Healthcare Research and Quality funded the USPSTF. Dr. Siu and team disclosed no conflicts of interest.

Review Date: 
January 21, 2016
Last Updated:
January 26, 2016