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Adults to be screened for depression, especially pregnant women

An influential US panel yesterday called for all adults to be screened for depression, including women during and after pregnancy, marking the first time it has urged a focus on maternal mental health.

The non-binding call was issued by the US Preventive Services Task Force, an independent, volunteer panel of experts that makes recommendations about the effectiveness of various health and counselling services.

“The USPSTF found convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings, including pregnant and postpartum women,” said the statement in the Journal of the American Medical Association.

It also found evidence that combining screening with “adequate support systems” may improve clinical outcomes by reducing or eliminating depression.

The guidelines update those issued in 2009 which did not specifically mention depression in women of childbearing age, but called for adult screening for depression when and where support systems allowed.

“Depression is among the leading causes of disability in persons 15 years and older,” said the latest report.

It is “also common in postpartum and pregnant women.”

The USPSTF “found convincing evidence” that treating adults with depression with antidepressants, psychotherapy, or both could improve patient outcomes.

It also pointed to “some harms” associated with antidepressants known as selective serotonin reuptake inhibitors (SSRIs) because they may increase suicide risk and are associated with “potential serious fatal harms.”

Since many questions remain about when to screen and how to treat depression, some experts are calling for increased responsiveness within the medical system.

“Until there are better methods to match patients with specific forms of treatment, the best hope to improve on a B grade for patients with depression may be to adapt care systems to respond more flexibly and decisively to key events,” said an accompanying editorial by doctor Michael Thase of the University of Pennsylvania, Philadelphia.

As many as one in seven women suffer from postpartum depression, according to the advocacy group Postpartum Support International.

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