The U.S. Preventive Services Task Force has issued a draft grade B recommendation endorsing depression screening in the general adult population, the group announced July 28.
The draft is an update to the 2009 USPSTF recommendation, which suggested screening only when staff-assisted depression care supports are in place.
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“In recognition that such support is now much more widely available and accepted as part of mental health care, the current recommendation statement has omitted the recommendation regarding selective screening, as it is no longer representative of current clinical practice,” the USPSTF said in a statement.
In addition, the new recommendation supports screening for depression in pregnant and postpartum women, groups that were not reviewed for the 2009 recommendation.
About 7% of the U.S. population met the criteria for a current depressive disorder from 2009 to 2012, according to the National Survey on Drug Use and Health and the National Health and Nutrition Examination Survey, the USPSTF noted.
“Major depressive disorder is a common and significant health care problem,” the statement said. “It is the leading cause of disability among adults in high-income countries and is associated with increased mortality due to suicide and impaired ability to manage other health issues.”
A USPSTF review of clinical trials found that adult patients reported a 46% remission rate with antidepressants and a 48% remission rate with psychotherapy after 10-16 weeks. A separate review concluded that older adults who received antidepressants were twice as likely to achieve remission as older adults who received placebo (odds ratio, 2.03), the task force reported.
In addition, a review of clinical trials that evaluated the effect of screening in pregnant and postpartum women showed 28%-59% reductions in risk of depression at follow-up, compared with usual care. Another trial, which evaluated screening plus provider support, found that 45% of intervention participants reported a 5-point or greater reduction in Patient Health Questionnaire-9 scores, compared with 35% of usual care participants (OR, 1.74), the report said.
Data from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions reported depression prevalence of 9.1% in pregnant women, 10.2% in postpartum women, and 13.1% in women in childbearing age who were not in the postpartum period.
“For pregnant and postpartum women, there is at least moderate certainty that the net benefit of screening for depression is moderate based on the evidence of benefits and harms when [cognitive behavioral therapy] or other evidence-based counseling is available,” the USPSTF reported.
The draft recommendation is open for public comment on the USPSTF website until Aug. 24.