USPSTF recommends population-wide depression screenings

The U.S. Preventive Services Task Force has recommended that all adults, including pregnant and postpartum women, be screened for depression, according to a draft recommendation statement.

In 2009, the USPSTF recommended selective screenings for depression based on provider judgement and patient preference, and only when care supports were in place. The updated draft eliminates the selective screening recommendation, and also addresses depression screening in pregnant and postpartum women — a group not specifically mentioned in the previous recommendations.

“Major depressive disorder … is a common and significant health care problem. It is the leading cause of disability among adults in high-income countries and is associated with increased mortality due to suicide and impaired ability to manage other health issues. Depression has a major impact on quality of life for the patients and affects family members, especially children. Depression also imposes a significant economic burden through direct and indirect costs. In the United States, an estimated $22.8 billion was spent on depression treatment in 2009, and lost productivity cost an additional $23 billion in 2011,” according to the recommendations.

While the recommendations support screening in all individuals, regardless of risk factors, the USPSTF noted women, patients who are young or middle aged, nonwhite, undereducated, unemployed, previously married; and individuals with chronic illnesses, other mental health conditions or a history of psychiatric disorders are at higher risk for depression.

Recommended screening tests include the Patient Health Questionnaire, the Hospital Anxiety and Depression Scales, the Geriatric Depression Scale and the Edinburgh Postnatal Depression Scale.

The USPSTF recommends treating depression in adults with antidepressants, psychotherapy or a combination of the two. In pregnant or postpartum women, cognitive behavioral therapy is recommended for depression treatment; moreover, the USPSTF encourages providers to consider the potential harms that pharmacological agents could inflict on the fetus or newborn, before prescribing antidepressants.

The public is invited to comment on the recommendations through August 24, 2015, before the final version is published.

Reference:

U.S. Preventive Services Task Force. Draft recommendation statement. Depression in adults: Screening. Available at: http://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement115/depression-in-adults-screening1. Accessed August 3, 2015.