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Few patients screened for alcohol use also screened for depression

Less than 3% of all patients screened for hazardous alcohol use were also administered the Patient Health Questionnaire-9 within 30 days of their first alcohol-use screening, according to findings recently published in the Journal of the American Board of Family Medicine.

Significant depressive episodes and hazardous alcohol use are commonly witnessed by primary care physicians, Matthew E. Hirschtritt, MD, MPH, a clinical fellow at the department of psychiatry at the Weill Institute for Neurosciences at the University of California San Francisco, and colleagues wrote.

“Despite the strong association between depressive symptoms and hazardous alcohol use, there are no data of which we are aware regarding rates of depression screening by alcohol use severity and demographic characteristics in primary care settings. This information would inform systematic efforts to detect and design tailored treatments for patients with significant depressive symptoms and hazardous alcohol use,” they added.

Researchers investigated the rate of depression screening by alcohol use severity among primary care patients screened for hazardous alcohol use. Among those assessed for depression, the researchers examined patterns of significant depressive symptoms.

Hirschtritt and colleagues found that among the 2,894,906 patients screened for alcohol use, only 2.4% also completed a Patient Health Questionnaire-9. These 68,686 patients were more likely to be younger, female, white, on Medicaid, and have a lower Charlson comorbidity score and nondepressive psychiatric diagnosis.

Additionally, nonwhite patients with higher Charlson comorbidity scores were more likely to endorse significant depressive symptoms and those considered moderate drinkers or abstainers were less likely than hazardous drinkers to complete the questionnaire or have significant depressive symptoms (score of 10 or greater).

“Our findings have important implications for the primary care setting. First, the low overall rate and relative rates of depression screening of certain groups (men, ethnic/racial minorities, more medically ill patients) highlight a specific area for system-wide improvement in primary care settings,” Hirschtritt and colleagues wrote. “Second, screening for and treating significant depression among primary care patients may improve the quality of medical care and decrease the burden of physical illnesses given the impact of depression on medical care.” – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.