All pregnant and postpartum women, should be screened for depression by their family doctor, the nation’s leading preventive medicine panel recommends. Further, doctors need to follow through and get treatment for anyone who tests positive for depression, the U.S. Preventive Services Task Force concluded in an update of its depression screening guidelines.
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This is the first time the panel has specifically advocated depression screening in pregnancy and shortly after giving birth. It cited a U.S. study that found that 9 percent of pregnant women and more than 10 percent of postpartum women exhibited signs of major depression.
The American College of Obstetricians and Gynecologists (ACOG) applauded the recommendation.
“Because fewer than 20 percent of women in whom perinatal depression is diagnosed self-report their symptoms, routine screening by physicians is important for ensuring appropriate follow-up and treatment,” said ACOG president Dr. Mark DeFrancesco in a statement.
stress, prenatal anxiety and decreased social support, the report said.
The new report — published Jan. 26 in the Journal of the American Medical Association — updates a similar recommendation the panel issued in 2009 that called for routine screening of adults.
In general, primary care physicians should be able to treat most cases of uncomplicated depression, and refer more complex cases to a psychiatrist, said Dr. Michael Pignone, a member of the task force and director of the University of North Carolina’s Institute for Healthcare Quality Improvement.
Options for treatment include therapy with a psychologist or licensed clinical social worker or antidepressant medications.
The task force is an independent, volunteer panel of national experts in preventive medicine. It issues recommendations, and revisits them on a regular basis to make sure that medical evidence still supports the guidelines.
Depression is among the leading causes of disability in persons 15 years and older, the panel noted.
Millions of adults suffer from depression and don’t know it, said Dr. Michael Thase, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine.
At any given time, between 5 percent and 10 percent of U.S. adults suffer from a depressive disorder, but half receive no treatment for their depression, Thase said.
Some people may not want to acknowledge they are depressed because there is a stigma around mental illness, Pignone said. Others might just think they are feeling blue, and will get over it.
The most common screening tool, the Patient Health Questionnaire, consists of 10 simple questions that can be answered in minutes, according to the U.S. Department of Health and Human Services.
“The task force recommendation is that people should be screened at least once,” he said. “For the meantime, clinicians should use their judgment about the risk of depression in their patients, in deciding how often to screen.”
Treating depression can help patients face other health problems with which they are struggling. “As depression gets worse, so many other chronic illnesses also get worse,” Manevitz said. “People don’t take care of their health as well when they are depressed.”
More information on treating depression and resources can be found at the Substance Abuse and Mental Health Services Adminstration. Visit them at www.SAMHSA.gov.
Depression Puts You At Risk For Other Health Problems
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