Depression case finding in primary care: a method for the mandates.
The current mandates for depression screening in primary care create a dilemma for clinicians. How should screening be implemented in the face of limited evidence for sustainable strategies for effective depression monitoring and management in primary care. In this article we review the issues surrounding primary care depression screening, and develop the argument for a case-finding strategy that includes careful choice of a single instrument, focused identification of high-risk patients, and systematic monitoring of outcomes. We believe this is a sustainable method that primary care clinicians can implement to address the spirit of current depression screening mandates.
Nease
Donald E
DE
Dept. of Family Medicine, University of Michigan, Ann Arbor 48109-0708, USA. dnease@umich.edu
Klinkman
Michael S
MS
Aikens
James E
JE
D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States