Share This Page

U.S. Preventive Services Task Force recommends depression screening for all adults

| Tuesday, Jan. 26, 2016, 11:00 a.m.

Guidelines revealed Tuesday by a leading medical panel recommend for the first time that women should be screened for depression during and immediately after pregnancy.

The U.S. Preventive Services Task Force updated its previous recommendations in two ways: First, family doctors should screen all adults 18 and older. Additionally, the task force specified that women who are pregnant or have recently given birth should be screened for depression by primary care doctors.

“I'm pleasantly surprised,” said Dr. P.V. Nickell, who chairs the psychiatry department at Allegheny Health Network. “I've been practicing for 30 years, and the attention mental health conditions are receiving continue to grow rapidly and appropriately.”

The task force did not include pregnant women in its 2009 suggestions and previously said adults should be screened only if physicians have enough staff to furnish treatment.

Depression is among the leading causes of disability in people 15 years and older, according to the task force, a group of experts who examine health needs on a national basis.

Nickell said clinical depression is the third-largest contributor to missed work days and reduced life expectancy behind cancer and heart disease. Symptoms of depression include: disturbances in appetite and sleep patterns, suicidal thoughts, poor concentration, lethargy and the loss of interest in activities or hobbies once pleasurable.

The task force found evidence that screening during primary care physician visits can help quell depression before symptoms worsen. Treatment can come in the form of talk therapy, antidepressant medication and electroconvulsive therapy.

“Depression is very treatable,” Nickell said. “There's no reason people with symptoms cannot expect a full recovery.”

While another doctor lauded progressive views toward removing all stigmas of depression, he questioned whether the recommendations go far enough.

Dr. Charles F. Reynolds III, UPMC Endowed Professor in Geriatric Psychiatry at the University of Pittsburgh School of Medicine, co-authored an editorial published Tuesday in JAMA Psychiatry entitled “Not Good Enough,” about the screening advice.

“We think it was a great start but still fell way short of the mark,” Reynolds told the Tribune-Review. “Our gripe is the task force tried to make depression screening a one-size-fits-all scenario. Clinical practice is far more varied than that.”

“Ideally, I'd like to see annual screenings and in some cases every six months for people who have recurrent depression,” Reynolds said.

He wrote in JAMA Psychiatry: “This is an important milestone in the journey toward healthy equity, but that journey is long, with miles to go.”

Ann Smith, president of the advocacy group Postpartum Support International, described the focus on pregnant women and new mothers as “fabulous.”

“Postpartum depression can be crippling,” she said. “I had it twice, and I will describe it this way: I felt so bad that if somebody had said, ‘I will cut off your right arm and you will feel better,' I would have put my arm right out there. That is how bad you feel. It is horrible.”

The experiences caused Smith, a nurse/midwife from New York, to become involved with Postpartum Support International, which was founded in 1987 and increases awareness about possible emotional changes that women experience during and after pregnancy.

In addition to the national recommendations, Allegheny Health Network said Tuesday it recently began its own pilot program for pregnant and postpartum women for enhanced depression screening. Women will be screened in selected key visits during and after pregnancies.

“The screening seems like a no-brainer,” said Dr. Pamela Kridgen of Seasons Ob Gyn, which is owned by AHN. “Depression is the elephant that sits in all of the rooms and this is another way of bringing it to people's attention that it can have very significant consequences and it is a very serious disease.”

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.

TribLIVE commenting policy

You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.