Screening urged for depression

Community Action, Jan 24, 2005

OTTAWA -- Routine screening of adult patients for depression will improve the detection of depression in clinical practices that have systems to assure an accurate diagnosis, effective treatment, and follow-up says a recently published article by the Canadian Task Force on Preventive Health Care in the Canadian Medical Journal.

As well, in its article, Screening for depression in primary care: recommendation statement from the Canadian Task Force on Preventive Health Care, authors Harriet MacMillan, Christopher J.S. Patterson, and C. Nadine Wathen noted that when routine screening for depression is linked with appropriate treatment and follow-up, the overall result was a reduced risk of depression.

These new recommendations are in stark contrast to recommendations made by the Task Force in 1994, when they concluded that there was fair evidence to exclude screening for depression in the primary care setting "because screening instruments did not improve the detection rate or management of depression," particularly for those at high risk, such as those with a family history of depression.

But after revisiting the topic by reviewing literature published in the last ten years, including a "rigorous review" of a 2002 systematic review conducted by the U.S. Preventive Services Task Force, the Canadian counterpart agreed with the U.S. findings, that "recurrent screening" for depression "may be most productive in patients with past history of depression, unexplained somatic symptoms, and morbid psychological conditions, such as panic disorder or generalized anxiety, substance abuse, or chronic pain."