Screening for Depression: Recommendations from the U.S. Preventive Services Task Force. Ann Intern Med. 2002;136:I56. doi: 10.7326/0003-4819-136-10-200205210-00005
Download citation file:
Published: Ann Intern Med. 2002;136(10):I56.
The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.
Depression causes sadness that interferes with daily life. Depression is a medical condition, not a normal reaction to a life situation such as the death of a loved one or the loss of a job. About 1 out of every 5 people suffers depression at some time in his or her life, and depression is common among patients who see primary care providers. Common depression symptoms are lack of energy and loss of interest in things previously enjoyed. Sometimes depression goes away on its own, but many depressed people need treatment with counseling or medication to speed recovery. Often, people with depression do not realize that their feelings are due to a medical condition and do not seek medical care for depression.
Some experts think that doctors should screen patients for depression. Screening involves looking for a disease in people who do not report symptoms. Patients found through screening can begin treatment. Screening works best when doctors' offices have systems in place to support accurate diagnosis, prescription of effective treatment, and careful follow-up of depressed patients. Benefits from screening are unlikely to be realized unless such systems are functioning well.
We know that depression is common and that asking patients about sad feelings can identify patients with depression. However, it has not been clear whether screening for depression by routinely asking patients about its symptoms improves patient outcomes.
The USPSTF reviewed published research to evaluate the benefits and harms of screening for depression.
Good evidence suggests that health care providers who routinely ask patients about sad feelings will identify more adults with depression. There is no evidence that one method of screening for depression works better than another. It does appear that two questions—1] Over the past 2 weeks, have you ever felt down, depressed, or hopeless? 2) Over the past 2 weeks, have you felt little interest or pleasure in doing things?—can identify patients with depression as well as longer sets of questions can. Good evidence shows that treating depression with counseling, medications, or both improves patient outcomes. Research on how frequently depression screening should occur is lacking. There is limited evidence about how well depression screening works in children and adolescents.
Adults who visit doctors for routine care may find that their doctors ask them about depression symptoms. If their answers to these questions suggest that they might have depression, the doctors should arrange a more thorough examination. Patients who are troubled by unexplained sadness, lack of interest in life, constant blue mood, and low energy should tell their doctors about these symptoms.
The USPSTF found limited evidence on how well screening for depression works when clinicians don't have tools to help improve diagnosis and treatment and allow appropriate follow-up. There is little information about which screening questions work best and how often they should be asked. The recommendations may become more specific as more studies are done.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only