Federal Task Force endorses routine screening for depression. (Primary Care Settings).

Regular screening of adult patients for depression is an effective strategy in primary care settings, the U.S. Preventive Services Task Force has concluded.

The recommendation addresses the concern that half of the 5%-10% of adults with major depression in the primary care setting are not identified, the USPSTF noted in its report.

The federally funded panel based its recommendation on 14 randomized, controlled trials that examined the effectiveness of regular screening for depression in primary care settings. The panel did not find enough studies of pediatric populations to recommend screening of children and adolescents. In its previous 1996 report, the task force did not find enough evidence to make a recommendation about screening in any age group.

In four studies, simply giving providers feedback about screening results did not significantly change treatment rates. But when such feedback was combined with treatment advice or other system supports, treatment rates were higher than with usual care in four of five trials.

Ten studies assessed the effect of feedback about screening results on patient outcomes from 1 month to 2 years later.

Five of these particular trials showed significant improvements in clinical outcomes; three other studies, however, showed only a trend toward improvement (Ann. Intern. Med. 136[10]:760-64, 2002).

The evidence from these trials suggests that 110 patients would need to be screened to produce one additional remission after 6-12 months of treatment. That estimate is based on the assumption that about 10% of adult patients in primary care have major, minor, or dysthymic depression.