title: Does screening for depression in primary care improve outcome?
abstract: 2012 marks one decade since the US Preventive Services Task Force recommended screening for depression. Advances since then include expanded understanding of the mechanisms underlying and influences of psychiatric disease on the development, course and outcomes of medical conditions. They also include collaborative care strategies to improve outcomes. However, the impact of such single disease approaches has been disappointing. Strategies that integrate management of multiple morbidities into primary care practice have greatly improved outcomes. Depression has been the only psychiatric condition incorporated into these strategies. Their expansion to integrate recognition and care of bipolar disease, anxiety disorders including PTSD, and substance abuse could further improve outcomes with modest marginal cost. Development of a screening and treatment monitoring instrument for multiple common psychiatric conditions is a prerequisite. One recently developed instrument, the M3, has the performance characteristics desirable, and provides opportunity to incorporate multiple common psychiatric conditions into multimorbidity integrated management.
authors.affiliation: Department of Family Medicine, Boston University School of Medicine, 1 BMC Place, Dowling 5, Boston, MA 02118, USA. Larry.Culpepper@BMC.org
authors.forename: Larry
authors.initials: L
authors.lastname: Culpepper
mesh_terms: D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D008605:Mental Health Services; D011314:Preventive Health Services / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D014481:United States