Little benefit from depression screening - study shows
By Catherine Walker
Routine screening for depression in primary care patients is costly, not clinically effective and may lead to false positives, according to a new study.
The Canadian researchers discovered that routine screening has not proved to be beneficial and is not an effective use of healthcare funds. They suggest that funds might be better used for providing more consistent treatment for people who already have a diagnosis of depression.
The analysis can be found in the Canadian Medical Association Journal.
Whilst a significant number of individuals go undiagnosed, screening for depression is a contentious topic. Clinical evidence supporting treatment for mild to moderate bouts of depression has not been validated they say.
As long as medical and mental health programming and resources are available for follow-up treatment for depression, screening for depression by primary care providers is recommended in the U.S. and Canada. The United Kingdom, however, does not recommend screening because of a lack of evidence supporting its efficacy.
The UK’s National Institute for Health and Clinical Excellence guidelines cited concerns about high rates of false-positive results, lack of evidence of benefit, high cost and large amount of resources, and the diversion of resources away from people with serious depression. This study suggests that they have it right.
‘The prevalence of depression and the availability of easy-to-use screening instruments make it tempting to endorse widespread screening for the disease,’ Brett Thombs, Ph.D., co-author wrote. ‘However, screening in primary care is a resource-intensive endeavour, does not yet show evidence of benefit and would have unintended negative effects for some patients.’
Many experts say that screening can be beneficial when it can identify people with an unrecognised and untreated condition that will improve with treatment. The authors recommend that providing consistent treatment to people with recurrent depression would be a more effective way of dealing with this disease than general screening.
Researchers say that clinical trials are necessary in order to evaluate the efficacy of screening. At this point evidence-based recommendations could be drafted.
‘Given the lack of evidence of benefit from screening and the concerns that we have described, it is not reasonable to simply assume that depression screening is a good policy,’ concluded the authors.
Source: Canadian Medical Association Journal
