Although it seems like nothing more than common sense, we were very pleased to see that the United States Preventive Services Task Force (USPSTF), which is the major organization responsible for guidelines for public health interventions in the United States, added depression screening for adults, in particular for pregnant women and women who recently given birth, to its short list of recommended public health interventions for primary care doctors.
Their recommendation ends by concluding “with at least moderate certainty that there is a moderate net benefit to screening for depression in adults, including older adults, who receive care in clinical practices that have adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up after screening.”
Regarding treatment, the task force says that “adequate evidence” supports programs that combine screening for depression with the presence of support systems that can help achieve better clinical outcomes.
“Convincing evidence” points to decreased clinical morbidity in patients who are identified through primary care depression screening and then treated with antidepressants, psychotherapy, or both.
The caveat in all of this, implied in the statement that screening is likely to be of benefit only where systems are in place to ensure adequate diagnosis, treatment and follow-up, is that we now find ourselves with a mental health system that, having been starved for funding for 15 years, is not up to the task of treating all of those who need help.
1. Siu A, et al. Screening for depression in adults: US Preventive Services Task Force Recommendation. JAMA. 2016;315(4):380-387.
2. Thase M. Recommendations for Screening for Depression in Adults. JAMA. 2016;315(4):349-350.
3. Reynolds C, Frank E. US Preventive Services Task Force Recommendation Statement on Screening for Depression in Adults: Not Good Enough. JAMA. 2016 Jan 26;[Epub ahead of print].