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 postpartum women.
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 healing."
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
