U.S. Preventive Services Task Force Now Finds Sufficient Evidence to
Recommend Screening Adults for Depression

Press Release Date: May 20, 2002

The U.S. Preventive Services Task Force now finds sufficient evidence to
encourage primary care clinicians to screen their adult patients for
depression.

Formal screening can make it easier to identify depression, a common and
treatable condition that often is not recognized by patients or their doctors.

At the same time, the Task Force noted that clinicians should have systems
in place to assure accurate diagnosis, effective treatment, and follow-up
if patients are to benefit from screening.

This recommendation, which will be published in the May 21 issue of the
Annals of Internal Medicine, updates the Task Force's 1996 recommendation.

In 1996, the Task Force identified depression as an important clinical
problem and encouraged clinicians to remain alert for signs of depression
in their patients, but it concluded there was insufficient evidence to
recommend for or against regular formal screening.

Since then, the Task Force has reviewed new evidence from randomized trials
that tested various screening tools and interventions for depression.

It found that patients fared best when clinicians recognized the symptoms
of depression and made sure that patients received appropriate treatment.

Although there are many tools available to screen for depression, there is
little evidence to recommend one over another. Clinicians can choose tools
that are appropriate for their patients and practice setting.

According to Task Force Chairman Dr. Alfred Berg, Chair of the Department
of Family Medicine, University of Washington, Seattle, "Our panel found
that asking two simple questions - over the past 2 weeks, have you ever
felt down, depressed, or hopeless, and have you felt little interest or
pleasure in doing things - may be as effective as using longer screening
instruments."

An affirmative response to these questions may indicate the need for the
use of more in-depth diagnostic tools.

The Task Force found that 5 percent to 9 percent of adult patients in
primary care settings suffer from depression.

Depression is often disguised by other problems, and up to 50 percent of
these cases go undetected and therefore, untreated.

Women, those with a family history of depression, the unemployed, and those
with chronic disease are among those at increased risk for depression.

Depression increases health care utilization and costs $17 billion in lost
workdays each year.

The Task Force concluded that the evidence is insufficient to recommend for
or against routine screening of children or adolescents for depression.

Although up to 2 percent of children and 4.5 percent of adolescents in
primary care settings suffer from depression; there is not enough research
about screening or treating this population in the clinical setting.

Clinicians should remain alert for possible signs of depression in younger
patients. Research in progress at the Agency for Healthcare Research and
Quality (AHRQ) will add to the currently limited evidence base for children
and adolescents.

The Task Force, sponsored by AHRQ, is a panel of independent,
private-sector experts in prevention and primary care.

It based its conclusions on a report sponsored by AHRQ's Evidence-based
Practice Center at RTI (Research Triangle Park, NC) and the University of
North Carolina (Chapel Hill) School of Medicine.

Depression is the eighth recommendation that the current Task Force has
released.

The depression recommendation is available online. Previous Task Force
recommendations, summaries of the evidence, easy-to-read fact sheets
explaining the recommendations, and related materials are available from
the AHRQ Publications Clearinghouse via email at [log in to unmask] and
through the National Guideline Clearinghouse.

To help clinicians apply Task Force recommendations in practice and to help
patients understand which clinical preventive services they should expect
clinicians to provide, AHRQ sponsors the Put Prevention Into Practice
(PPIP) program.

Information about the PPIP program and products, and a list of other USPSTF
products under review, is available online.

For additional information, please contact AHRQ Public Affairs, (301)
594-1364: Barbara Najar, (301) 594-9881 ([log in to unmask]) or Farah Englert,
(301) 594-6372 ([log in to unmask]).

Agency for Healthcare Research and Quality, Rockville, MD.
http://www.ahrq.gov/news/press/pr2002/deprespr.htm

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