The Canadian Task Force on Preventive Health Care (CTFPHC) has revised their 2005 guidelines on routine screening for depression in primary care settings for adults who are at average risk, or who have characteristics that may increase their risk of depression, if they have no apparent symptoms. Contrary to the previous guideline, the CTFPHC now states that, “In the absence of a demonstrated benefit of screening and in consideration of the potential harms, we recommend not routinely screening for depression in primary care settings.” References to potential harm by the CTFPHC included examples where mild forms of depression that were “carefully watched” resolved spontaneously, unlike other cases where adverse effects and complications arose as a result of treatment. Concerns over “false-positive” diagnoses and unnecessary treatment were also cited as examples of potential harms.
This guideline does not apply when patients have a history of depression or are currently receiving treatment.
Instead of routinely screening, the CTFPHC now advises clinicians to be alert to symptoms of depression, such as low mood, insomnia, anhedonia, low mood and suicidal thoughts. When symptoms are present, an assessment of depression should then be made.
The discussion and revised CTFPHC guideline was published online in the Canadian Medical Association Journal, May 13, 2013.
You can read the related Science Daily article, “Routine Screening for Depression Not Recommended for Adults With No Apparent Symptoms of Depression” on the Science Daily website.