About Careers MedBlog Contact us

Screen All Adults and All Teens for Depression

by Bidita Debnath on February 24, 2017 at 11:57 PM
Font : A-A+

 Screen All Adults and All Teens for Depression

Recent advice on depression screening from the US Preventive Services Task Force (USPSTF) may lead to overtesting and overtreatment, claim experts.

The advice - to screen all children aged 12 years and older and all adults for depression - contrasts with Britain and Canada which recommend against routine screening, and is one of several recommendations issued by the task force in the past few years that are far more liberal in promoting interventions.


In a special report published, The BMJ Associate Editor Jeanne Lenzer asks whether the task force - widely respected for its independent, objective guidance on preventive services - is still a voice of caution.

Some task force recommendations rely on questionable research methodologies, writes Lenzer.

For example, Brett Thombs, professor of psychiatry at McGill University told The BMJ: "In the absence of any trial evidence that screening would benefit patients, there is real concern that these recommendations may lead to more harm than good."

However, Kirsten Bibbins-Domingo, current USPSTF chair and professor at the University of California, San Francisco, said: "We evaluate the available evidence around preventive services by assessing a variety of valid trial designs and rigorously examining studies for potential bias."

A second concern, says Lenzer, stems from the fact that USPSTF recommendations have been based on evidence reviews that have not always included unpublished data.

She acknowledges that many systematic reviews, even outside USPSTF, do not include unpublished data from regulators and manufacturers, but points to research by Erick Turner, a psychiatrist and former FDA reviewer, highlighting the dangers of omitting unpublished data.

Albert Siu, immediate past chair of the task force, defended its reliance on published data, saying peer review "can address many sources of potential bias and methodological limitations." Although others reject this logic.

Lenzer also points to USPSTF's outsourcing of evidence reviews to evidence based practice centres (EPCs), which she says "raises questions of whether financial conflicts could affect task force recommendations."

Although The BMJ found that both USPSTF members and the individual EPC researchers selected to work on reviews were almost entirely free of financial conflicts, several EPCs receive industry funding, raising questions of potential institutional conflicts of interest.

Finally, some experts contacted by The BMJ said that the USPSTF's advice for depression screening will lead to inappropriate treatment. Allen Frances, a well known critic of overdiagnosis, told The BMJ that current services for severely mentally ill people were already strained to bursting point, saying "we don't need to create an army of mislabeled healthy people."

Others say that before making population based screening and prevention recommendations, independent researchers should analyse more forms of raw data such as clinical study reports and patient level data - and when such rigorous analyses are not possible it is important to acknowledge the resulting uncertainty.

"What we need are fewer recommendations and more high quality evidence to base decisions on," argues Carl Heneghan, professor of evidence based medicine at the University of Oxford. "Currently we seem to be seeing the exact opposite."

Lenzer included a similar review of the task force recommendation on statins for primary prevention of heart disease.

Source: Eurekalert


Recommended Reading

Latest General Health News

More Than 300 People on Texas-Mexico Cruise Ship Fall Sick
Over 300 people had fallen sick with illness caused by Norovirus on a US cruise ship, say authorities.
 No Smoking Day 2023: Ex-smokers in Wakefield Lead the Campaign
Ex-smokers in Wakefield have shared their stories to encourage others to give up cigarettes on No Smoking Day 2023 which falls on 8th March.
New Protein Linked to Neurodegeneration
Total levels of m6A in the nervous system rise with age and that (some) neurodegenerative diseases are characterized by RNA hypermethylation.
How Stress Disrupts Maturation of Brain's Reward Circuits?
New study provides insights into the impact of early-life adversity on brain development and on control of reward behaviors that underlie emotional disorders
 Indonesia Partners With FIND for Diagnostic Testing Access Initiative
Ministry of Health of the Republic of Indonesia signed a formal memorandum of understanding (MOU) that will expand access to essential diagnostics in the country.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close

Screen All Adults and All Teens for Depression Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests