Every Adult Should Be Screened for Depression

The US Preventive Services Task Force has issued two big changes to its recommendations for depression screening:

• Every adult should be screened for depression at some point. Primary care physicians, including family doctors and gynecologists, should include screenings as a routine part of every over-18 patient's care, CNN reports. The Patient Health Questionnaire, a nine-question test with questions about mood, appetite, fatigue, and concentration, among other things, can identify 80% of depression cases, per an editorial on the new recommendations in JAMA. There is also a seven-question test that can be used; patients often complete such tests while waiting to see a doctor, and anyone who is found to be at risk gets a more thorough evaluation.

• Pregnant women should be screened for depression while pregnant and after giving birth. Maternal mental illness has been found to be more common than was previously believed, the New York Times reports, and new research has also found that postpartum depression often starts during pregnancy. PPD can lead to premature birth, low birth weight, and even mood disorders and developmental delays in babies born to affected mothers. A 10-question test called the Edinburgh Postnatal Depression Scale is recommended. Because the safety of antidepressants while pregnant or breastfeeding is not 100% confirmed, doctors are recommended to try therapy as a first line of treatment in at-risk cases.

The last set of recommendations, issued in 2009, only said adults should be screened if clinicians have the resources to treat depression; the new guidelines say that systems should be in place to ensure "accurate diagnosis, effective treatment, and appropriate follow-up," MedPage Today reports. The 2009 recommendations did not specifically mention depression related to pregnancy and the postpartum period. (More depression stories.)