The US Preventive Services Task Force (USPSTF) released its updated recommendation statement on screening for depression in adults aged ≥18 years. The USPSTF recommends screening for depression in the general adult population, including older adults, pregnant and postpartum women, regardless of risk factors. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation)

The USPSTF found convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings, including pregnant and postpartum women. It also found convincing evidence that treatment of adults and older adults with depression identified through screening in primary care settings with antidepressants, psychotherapy, or both decreases clinical morbidity. Adequate evidence that treatment with cognitive behavioral therapy (CBT) improves clinical outcome in pregnant and postpartum women with depression was also noted. The net benefit of screening for depression in the general adult population is moderate, according to the statement.

Citation: Siu AL, et al. Screening for depression in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(4):380-387. doi: 10.1001/jama.2015.18392.

Commentary: Depression is the leading cause of disability in adults in high-income countries, affects the quality of life of individuals and their families, and has high direct and indirect health care costs. It affects about 10% of the general population and about twice that percentage in high risk groups, including those with many chronic diseases. If the answer is positive then a more detailed evaluation is indicated. The recommendation statement also discusses that both SSRIs and CBT have demonstrated efficacy in the treatment of depression, with both having a rate of remission of depression of about 50% over 10 to 16 weeks. SSRIs have more side effects than CBT, with an increased rate of suicide in adults 18 to 29 years of age and an increased risk of GI bleeding in adults age > 65, with the rate increasing substantially with increasing age. —Neil Skolnik, MD