Depression is a major health issue that afflicts millions of Americans.
So it's not surprising that recent screening guidelines issued by
the U.S. Preventive Services Task Force recommend that all adults over
the age of 18 should be tested for depression--including pregnant and
The statement from the task force, a volunteer panel of medical experts
that draws up national recommendations for preventive health care, is
an update of its 2009 depression screening guidelines. The old guidelines
recommended adults be screened for depression if they had access to support
and treatment, or a doctor could selectively screen patients. Pregnant
and postpartum women were not specifically included in the 2009 recommendation.
"Doctors aren't required to follow these guidelines, but they
are in line with similar recommendations from other physicians' groups.
Depression screening can be beneficial and it should be offered to adults
as part of overall wellness care," says
James Yoon, MD, a board-certified family medicine physician at
St. Jude Heritage Medical Group. "Depression can be so debilitating--diagnosing and treating it as
early as possible can be a saving grace for a patient, as well as their
families and loved ones."
Dr. Yoon adds that there's no reason to not screen patients for depression,
given that mental health services are more plentiful than in 2009, when
the task force recommended selective screenings. "Doctors can make
referrals to specialized mental health clinicians and caregivers and work
with them as a medical team to devise a treatment plan."
Another factor in favor of screening is that the most common tools--brief
questionnaires--are straightforward to use. "The questions generally
focus on the patient's mental and physical state during the past two
weeks, which is the minimum time period for what's considered a major
depressive episode," Dr. Yoon says. "Poor appetite, trouble
sleeping, difficulty concentrating, a lack of pleasure in life--those
are all subjects that can be covered in the questionnaire. Certain groups,
such as the elderly, can take a questionnaire geared toward them."
Dr. Yoon says incorporating the screening during an exam can be good, as
a doctor can at the same time rule out any physical ailments that could
be triggering a patient's feeling of depression.
The task force's inclusion of pregnant and postpartum mothers in its
screening guidelines is also good news, says Dr. Yoon. "It acknowledges
the toll depression takes on new and expectant mothers, and its profound
impact on them as well as their families."
While the guidelines don't state an optimal time for depression screening
in adults, they do say that physicians should be prepared to offer treatment
plans if a patient is diagnosed with depression. "That can include
staff members specially trained to work with depressed patients, materials
for patient education or a referral system to get people the help they
need," Dr. Yoon says. "Depression is a complex condition with
many factors, but screening is a crucial first step on the journey toward
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