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Maternal and Child Health

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​Screening for Depression

The U.S. Preventive Services Task Force (USPSTF) recommends screening adults for depression “when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.” (Grade B recommendation)1

Sample evidence-based screening tools for depression:
  • Consider initially screening with PHQ-2 in all patients2

    Over the last 2 weeks, how often have you been bothered by any of the following problems?
1.       Little interest or pleasure in doing things
0 = Not at all
1 = Several days
2 = More than half the days
3 = Nearly every day
2.       Feeling down, depressed, or hopeless
0 = Not at all
1 = Several days
2 = More than half the days
3 = Nearly every
A score greater than or equal to 3 suggests possible depression.
  • PHQ-9 – sensitivity of 61% and specificity of 94%2: http://phqscreeners.com/pdfs/02_PHQ-9/English.pdf
  • Geriatric depression scales may be used in patients 65 years and older2
  • Beck Depression Inventory (BDI-II) is another valid screening tool for depression3

 

Sample evidence-based screening tool for Premenstrual Dysphoric Disorder (PMDD):
Screening alone does not improve health outcomes – it needs to be combined with depression care and treatment in order to be effective5
 
Depression screening qualifies as a free preventative service under the Affordable Care Act6
 
 References:
  1. U.S. Preventive Services Task Force. Screening for depression in adults. December 2009. http://www.uspreventiveservicestaskforce.org/uspstf09/adultdepression/addeprrs.htm. Accessed December 2, 2014.
  2. Maurer DM. Screening for depression. Am Fam Physician. 2012 Jan 15; 85(2):139-44.
  3. Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: a comprehensive review. Rev Bras Psiquiatr. 2013 Oct-Dec; 35(4):416-31.
  4. Biggs WS, Demuth RH. Premenstrual syndrome and premenstrual dysphoric disorder. Am Fam Physician. 2011 Oct 15; 84(8):918-24.
  5. O'Connor EA, Whitlock EP, Beil TL, Gaynes BN. Screening for depression in adult patients in primary care settings: a systematic evidence review. Ann Intern Med. 2009 Dec 1; 151(11):793-803.
  

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12/2014