Screening for depression in high-risk groups: prospective cohort study in general practice.
BACKGROUND
Currently only about half of the people who have major depressive disorder are detected during regular health care. Screening in high-risk groups might be a possible solution.


OBJECTIVE
To evaluate the effectiveness of selective screening for major depressive disorder in three high-risk groups in primary care: people with mental health problems, people with unexplained somatic complaints and people who frequently attend their general practitioner.


METHODS
Prospective cohort study among 2005 people in high-risk groups in three health centres in The Netherlands.


RESULTS
Of the 2005 people identified, 1687 were invited for screening and of these 780 participated. Screening disclosed 71 people with major depressive disorder: 36 (50.7%) already received treatment, 14 (19.7%) refused treatment and 4 individuals did not show up for an appointment. As a final result of the screening, 17 individuals (1% of 1687) started treatment for major depressive disorder.


CONCLUSIONS
Screening for depression in high-risk populations does not seem to be effective, mainly because of the low rates of treatment initiation, even if treatment is freely and easily accessible.
Baas
Kim D
KD
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Wittkampf
Karin A
KA
van Weert
Henk C
HC
Lucassen
Peter
P
Huyser
Jochanan
J
van den Hoogen
Henk
H
van de Lisdonk
Eloy
E
Bindels
Patrick E
PE
Bockting
Claudi L
CL
Ruhé
Henricus G
HG
Schene
Aart H
AH
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005194:Family Practice / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D012307:Risk Factors