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U.S. Preventive Services Task Force

Screening for Depression in Adults

Clinical Summary of U.S. Preventive Services Task Force Recommendation

This document is a summary of the 2009 recommendation of the U.S. Preventive Services Task Force on screening for depression in adults. It is intended for use by primary care clinicians. This summary was first published in Annals of Internal Medicine in December 2009 (Ann Intern Med 2009;151:791).

Population Nonpregnant adults 18 years or older
Recommendation Screen when staff-assisted depression care supports* are in place to assure accurate diagnosis, effective treatment, and follow-up.

Grade: B
Do not routinely screen when staff-assisted depression care supports* are not in place.

Grade: C
Risk Assessment Persons at increased risk for depression are considered at risk throughout their lifetime. Groups at increased risk include persons with other psychiatric disorders, including substance misuse; persons with a family history of depression; persons with chronic medical diseases; and persons who are unemployed or of lower socioeconomic status. Also, women are at increased risk compared with men. However, the presence of risk factors alone cannot distinguish depressed patients from nondepressed patients.
Screening Tests Simple screening questions may perform as well as more complex instruments. Any positive screening test result should trigger a full diagnostic interview using standard diagnostic criteria.  
Timing of Screening The optimal interval for screening is unknown. In older adults, significant depressive symptoms are associated with common life events, including medical illness, cognitive decline, bereavement, and institutional placement in residential or inpatient settings.  
Balance of Harms and Benefits   Limited evidence suggests that screening for depression in the absence of staff-assisted depression care does not improve depression outcomes.
Suggestions for Practice "Staff-assisted depression care supports" refers to clinical staff that assists the primary care clinician by providing some direct depression care and/or coordination, case management, or mental health treatment.
Relevant USPSTF Recommendations Related USPSTF recommendations on screening for suicidality and screening children and adolescents for depression are available at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
*Go to the Suggestions for Practice section of this figure for further explanation.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

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AHRQ Publication No. 10-05143-EF-3
Current as of December 2009

Internet Citation:

U.S. Preventive Services Task Force. Screening for Depression in Adults: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 10-05143-EF-3, December 2009. http://www.uspreventiveservicestaskforce.org/uspstf09/uspstf09/adultdepression/addeprsum.htm


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