Strong Support for Routine Depression Screening
The US Preventive Services Task Force (USPSTF) has recently updated its recommendation on the screening of depression in the general adult population. The USPSTF is an independent panel of experts in primary care and prevention. The task force is responsible for systematically reviewing the evidence of the effectiveness of screening for diseases and developing recommendations for clinical preventive services. The recent USPSTF recommendation endorsed its previous call (from 2009) for screening of all individuals at the primary care level for depression, but also added screening of pregnant and postpartum women, regardless of risk factors. They issued the following statement:
“The USPSTF concludes with at least moderate certainty that there is a moderate net benefit to screening for depression in adults, including older adults, who receive care in clinical practices that have adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up after screening,"
This recommendation is based on the body of empirical evidence that shows that early identification of depressive symptoms can lead to effective treatment, assuming that treatment is available. Clinicians can choose among numerous screening instruments. For adults (older than 50) and older adults, the Brief Anxiety and Depression Scale (BADS) is an ideal depression screening tool that is consistent with the USPSTF recommendation. Unlike most depression screening instruments, the BADS is validated for people with or without dementia, can be completed by the patient or as a proxy measure (by a knowledgeable informant), and can be completed in less than three minutes.
Certainly the treatment of depression is very important, as depression is a common and potentially debilitating illness. In addition, there is a possible link between depression (especially chronic depressive episodes) and dementia. As many of you are aware, the BCAT Research Center is a strong advocate for the ANTHEM approach to reducing the risk of cognitive impairment in the older adult years. ANTHEM recognizes that one may reduce the risk of dementia by practicing six healthy habits, beginning in middle-age. The “T” in ANTHEM refers to the importance of identifying and treating depressive episodes. Screening for depression is not only important for treating depression, but could also reduce the risk of dementia in the older adult years.
For more information about the USPSTF recommendation about depression screening, visit this page.