title: Does depression screening have an effect on the diagnosis and treatment of mood disorders in general medical settings?: an instrumental variable analysis of the national ambulatory medical care survey.
abstract: This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.
authors: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. rmojtaba@jhsph.edu
authors: Ramin
authors: R
authors: Mojtabai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002648:Child; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents