January 26, 2016
Panel Urges Screening For Depression, Singles Out Pregnant Women

In a recently released final recommendation statement regarding adult depression in the United States, an influential panel urges screening for every adult the country. The panel also singles out pregnant women in particular, suggesting that expectant mothers should receive special attention both during and after pregnancy.

The recommendation statement comes from a panel convened by the U.S. Preventive Task Force, which consists of professionals appointed by the U.S. Department of Health and Human Services. Although the U.S. Preventive Task Force is appointed by the Department of Health and Human Services, it is an independent body, so the final recommendation regarding screening for depression in adults does not represent an official stance of any U.S. government agency.

In fact, the final recommendation statement points out that the panel is simply charged with determining the efficacy of various treatments and screenings, without taking into account any external factors such as feasibility or cost.

"The USPSTF makes recommendations about the effectiveness of specific preventive care services for patients without related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service, and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment."
The updated recommendation was published in the Journal of the American Medical Association on January 26, 2016, and it urges "screening for depression in the general adult population, including pregnant and postpartum women." It also recognizes that pregnant and postpartum women are particularly at risk, and that depression can adversely effect both the woman and her child.

panel urges depression screening from doctors
The panel determined that the best way to provide regular screening for depression is through primary care physicians. [AP Photo/Jay LaPrete]According to The Washington Post, this marks the first time that the panel has updated its recommendations on screening for depression in adults since 2009.

The Washington Post also reports that the panel determined that major depressive disorders are associated with both suicide and an impaired ability to provide self-care, and that there are tremendous real world economic costs associated with depression.

The U.S. Preventive Task Force's final recommendation indicates that in the United States alone, $22.8 billion was spent on the treatment of depression in 2009, and that lost productivity associated with untreated depression carried a price tag of $23 billion in 2011.

According to the panel, the best way to catch depression early is through regular screenings carried out by a primary care physician.

"In the United States, like many other economically developed nations, primary care practices represent the best place for implementation of these methods, because it is the only venue where both screening and, if clinically indicated, treatment can be provided," Doctor Michael E. Thase wrote in an article that accompanied the publication of the U.S. Preventive Task Force's report in the Journal of the American Medical Association. "Indeed, the STAR*D study5 showed that patients treated in primary care practices who were provided with a moderate level of clinical support had the same chances for response and remission as patients treated in psychiatric practices."

The panel also found that "the magnitude of harms of screening for depression in adults is small to none," meaning that there are benefits to screening and no discernible harmful effects. The panel found similar results in regards to screening pregnant and postpartum women.

panel urges aca depression screening
The B grade assigned to depression screening means that it should be available under the Affordable Care Act. [AP Photo/Don Ryan, File]Due to these findings, the panel assigned a B grade to its recommendation, signifying that the benefits of screening for depression outweigh the harms. This grade, which is the second highest that the task force can assign, indicates that regular screenings for depression should be implemented under the Affordable Care Act as preventive care.

Do you feel like your primary care physician is competent, or willing, to adequately perform this type of screening?

[Photo by AP Photo/Jacquelyn Martin]