As one of the most common mental disorders in the U.S., depression is a serious condition directly affecting millions of people, as well as their surrounding support network of friends and family. In a response to the mounting awareness of mental health, figuring out who may be suffering and providing them with the help and support they need is crucial. In light of this, the U.S. Preventive Services Task Force (USPSTF) has recommended that doctors should screen everyone over the age of 18 for signs of depression, and provide them with the necessary care.
The advice is an update on the 2009 recommendations by the USPSTF – which is made up of an independent panel of experts – and as well as suggesting that all adults should be screened, they also advocate that pregnant women and those who have recently given birth should also be assessed, as they were not previously included in the earlier recommendations. The USPSTF say that they have found “convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings.”
By combining early screening with the provision of treatment, such as psychotherapy, counselling services, or antidepressants, there is a moderate to high chance that the clinical outcomes, like reduction or remission of depression symptoms, will be improved.
“Until there are better methods to match patients with specific forms of treatment,” says Dr. Michael E. Thase, a professor of psychiatry at the University of Pennsylvania, “the best hope to improve on a B grade [meaning the net benefit is moderate to substantial] for patients with depression may be to adapt care systems to respond more flexibly and decisively to key events that are associated with nonadherence or treatment failure.”
The USPSTF looked at all aspects of early detection and treatment of depression among adults and specifically pregnant and postpartum women, including the potential harm caused. They found that the harm in early detection and treatment for adults was practically none, but did warn about the treatment of pregnant and postpartum women. They recommend that treatment for this group should focus on counselling and therapy, rather than the prescription of antidepressants, which could have an impact on an unborn or breastfeeding child.
There have, however, been warnings about over-diagnosing mental disorders such as depression, especially in the United States. The last 20 years have seen a 400 percent increase in the use of antidepressants, with an estimated one in ten adults now taking them, despite limited evidence for their efficacy. One study, for example, has suggested that as many as 60 percent of adults treated for depression, and prescribed medication to help ease it, didn’t meet the official criteria for the disorder.
