Screening for Depression

Depression is a major cause of disability among adults in the United States. It affects not only individuals but also their families, children, and work environments. Screening for depression can lead to earlier diagnosis of the illness, which leads to earlier treatment.

Screening for depression refers to medical professionals routinely asking about symptoms of depression, even if their patients do not mention them. Depression symptoms include feeling sad, hopeless, tired, distracted, or not interested in activities that would normally interest you. Sometimes patients do not feel comfortable bringing up these symptoms with their doctors unless they are directly asked about them. It is also common for depression to present with physical symptoms, such as headaches, back pain, or abdominal pain. These symptoms can make detecting the underlying issue of depression difficult unless a health care professional directly asks about it.

Several questionnaires are used to screen for depression. Those most commonly used in the primary care setting include the Patient Health Questionnaire and the Beck Depression Inventory for Primary Care. These questionnaires range from 2 to 9 questions and take only a few minutes to complete.

The January 26, 2016, issue of JAMA contains an article describing the US Preventive Services Task Force’s current recommendations for depression screening. The recommendations state that

• All adults older than 18 years should be routinely screened for depression. This includes pregnant women and new mothers as well as elderly adults.

• In addition to screening, systems should be in place to ensure proper diagnosis, treatment, and follow-up care for depression.

These recommendations were made based on an extensive review of evidence on the benefits and harms of screening for depression, the accuracy of screening tools being used, and the benefits and harms of treatment for depression.

There are many effective ways to treat depression, including counseling, cognitive behavioral therapy, medications, or a combination of these approaches. A JAMA Patient Page on depression was published in the May 19, 2010, issue and one on postpartum depression in the October 20, 2010, issue.