Should We Screen People for Depression?
Screening for depression is unlikely to be an effective way to improve the mental wellbeing of the population, say researchers in this week's BMJ.
Nevertheless, it may soon become health policy in England and Wales as primary care doctors are rewarded for screening under their new contract.
Using UK National Screening Committee criteria, the research team scrutinised the rationale and evidence to support such screening.
They found that, although depression qualifies as a major public health problem, criteria regarding test performance, acceptability, and treatment benefits were not met.
Other key criteria are unlikely to be achieved, say the authors. For example, that the benefit from screening should outweigh the harm and that the screening programme should be cost effective.
Opportunistic screening and population level screening for depression do not fulfil the criteria of the National Screening Committee, say the authors. However, the assumption has been made that screening for depression should be recommended.
Screening should only be considered as part of a package of enhanced care. Without this, moves to implement screening will be associated with increased costs and no benefit, they conclude.
An accompanying editorial argues that it is time we treated depression as the chronic disease that it is.