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Depression Screening Is Not Enough

Kurt Kroenke, MD
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Dr. Kroenke: Regenstrief Institute for Health Care; Indianapolis, IN 46202

Requests for Single Reprints: Kurt Kroenke, MD, Regenstrief Institute for Health Care, RG-6, 1050 Wishard Boulevard, Indianapolis, IN 46202; e-mail, kkroenke@regenstrief.org.

Ann Intern Med. 2001;134(5):418-420. doi:10.7326/0003-4819-134-5-200103060-00014
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Not enough” does not mean “not at all.” The individual and societal burden of depression is enormous in terms of economic costs (over $40 billion annually in the United States alone); disability days; and pervasive effects on physical, mental, and social well-being (13). This burden, coupled with the eminent treatability of depression, compels us to action (45). The first action must be recognition of the depressed patient, without which amelioration is impossible. The second action is treating the patient in whom depression has been identified. Although screening can enhance both recognition and initiation of treatment (6), improvement in depression outcomes requires a third step: careful follow-up and monitoring of treatment effectiveness.

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