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Screening all adults for depression
during their annual medical exam would be a first step in treating millions
of Americans who suffer from the condition.
The team from the Agency for
Healthcare Research and Quality emphasized that doctors should also be
able to treat their patients with antidepressants or recommend other approaches
such as behavioral therapy, and then follow-up with patients if the benefits
of the initial screen are to be realized.
The recommendation marks a
change from the previous statement issued in 1996. This paper concluded
there was not enough evidence to advise regular formal screening. Instead,
doctors were encouraged to recognize symptoms of depression such as lethargy
and a loss of interest in people or activities previously enjoyed.
In the past 8 years, however,
studies have shown that patients can benefit from a regular simple screening
and follow-up.
No single screening tool or
procedure is more effective than another. Simply asking patients how they
are doing may be enough. For instance, a patient who admits to feeling
hopeless or receiving little pleasure from normally enjoyable activities
may be a candidate for more in-depth diagnostic tests.
According to the US Preventive
Services Task Force, up to one half
of the 5% to 9% of adult patients who suffer from depression go undiagnosed.
Women, patients with chronic disorders, unemployed people and
those with a family history of depression are most at risk.
Annals
of Internal Medicine 2002;136:760-764
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