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Screening for depression in high-risk groups: prospective cohort study in general practice
Kim D Baas1, Karin A Wittkampf, Henk C van Weert
1Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Summary
Selective screening for major depressive disorder in high-risk groups showed low effectiveness. Many individuals did not initiate treatment, even when it was accessible, indicating challenges in depression care pathways.
Area of Science:
- Primary Care Research
- Mental Health Screening
- Depression Epidemiology
Background:
- Major depressive disorder (MDD) is often undetected in primary care, with only about 50% of cases identified.
- Screening high-risk populations presents a potential strategy to improve MDD detection rates.
Purpose of the Study:
- To assess the efficacy of selective screening for MDD within primary care settings.
- The study focused on three identified high-risk groups: individuals with existing mental health issues, those with unexplained physical symptoms, and frequent attendees of general practice.
Main Methods:
- A prospective cohort study was conducted involving 2005 individuals from high-risk groups across three Dutch health centers.
- Participants were screened for major depressive disorder, with subsequent analysis of treatment initiation rates.
Main Results:
- Out of 1687 individuals invited for screening, 780 participated, identifying 71 with MDD.
- Of those diagnosed, a significant portion (50.7%) were already receiving treatment, while 19.7% declined treatment.
- Ultimately, only 17 individuals (1% of those screened) initiated new treatment for MDD.
Conclusions:
- Selective screening for MDD in high-risk populations appears ineffective due to low treatment initiation rates.
- Accessibility of free and easy treatment did not significantly improve uptake, highlighting barriers in the depression care pathway.
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