All adults need to be screened for depression: US Task Force

By Sabir Shah
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January 27, 2016

LAHORE: As diagnoses of depression are growing globally at an alarming rate, along with strokes, obesity, cancer and heart diseases etc, the United States Preventive Services Task Force has strongly recommended that primary care physicians should screen all adult patients at least once for the state of persistent low mood.

These recommendations have also been published in the latest edition of the Journal of the American Medical Association and similar findings have also been highlighted often through eyebrow-raising info graphics by various reputed and widely-visited health websites, which agree that depression affects a person’s thinking patterns, behaviour and sense of well-being.

A recent report of the CNN states: “The recommendations by the task force, an independent expert panel, update its 2009 advice in two important ways: First, everyone 18 and older should be screened, the panel said -- and not just at clinics where systems are in place to connect at-risk individuals to mental healthcare.

Second, primary care doctors should screen women who are pregnant or have recently given birth, two groups not included in earlier recommendations.” Quoting Dr. Michael P. Pignone, professor of medicine at the University of North Carolina School of Medicine and one of the authors of the recommendations, the CNN has maintained: “In the case of these new recommendations, primary care doctors include not just family doctors but also gynaecologists, who provide many women with primary care, and obstetricians when women are pregnant and in the months following their delivery.”

The leading US news channel has further reported: “An estimated seven per cent of adults in the United States suffer depression every year. As the authors of the task force recommendations wrote, depression is the top cause of disability among adults in high-income countries, increases the risk of death and decreases the quality of life for patients and their family members.”

The top American media house has gone on to opine: “A common scenario for screening is that a patient completes a test on paper or electronically while waiting to see the doctor. If the test reveals a patient is at risk of depression, a doctor or nurse does a more thorough evaluation and talks with the patient about whether to start antidepressants or therapy. Research has found that a nine-question test called the Patient Health Questionnaire does a good job of identifying people who are risk of having depression. In addition to asking about mood, fatigue and concentration, it asks people about their appetite, whether they have been interested in activities and whether they have thought about hurting themselves in the last two weeks. The task force also recommends a seven-question test as an alternative for screening the general population. Older adults and women during the perinatal period should be screened with variations of these tests. There is good evidence for the effectiveness of these tests, but they do have flaws.”

According to CNN, research has linked depression during pregnancy since untreated depression in women could affect the baby as well as the mother.

The CNN report has held: “Research has linked depression during pregnancy and post-partum with preterm birth and low birth weight, mood problems and developmental delays in the infant, among other complications. The task force provides advice about treatment of these women. Because there are still questions surrounding the safety of antidepressants for fetuses and breast-feeding babies, they recommend that clinicians first try treating women with therapy, such as cognitive behavioural therapy.”

Earlier in its August 3, 2015 report, the CNN had revealed: “One

in seven women experience depression during pregnancy or the first year after giving birth, yet many may not realize it or report their concerns to clinicians. A new proposal by the US Preventive Services Task Force could help change that. It recommends that all women who are pregnant or within a year of giving birth be screened for perinatal depression, as it's called. The screening proposal is included as part of a broader recommendation to screen all adults for depression that the task force released this week for public comment. The task force proposal would update the current guidelines, adopted in 2009, which recommend depression screening in all adults if clinicians are available to address depression care. In the 2009 document, the task force didn't review depression in pregnant and post-partum women and made no screening recommendation for them.”

Ranked as the fourth leading cause of disability worldwide by World Health Organisation (WHO) Survey across 60 countries last year and projected to be the second key reason by 2020, depressed humans not only lose interest in activities that were once pleasurable, but they also experience loss of appetite and might go on to contemplate, attempt or commit suicide.