Primary care docs rarely screen patients for depression, study finds

Doctor patient
Primary care doctors rarely screen patients for depression, a new study found.

Despite federal recommendations that healthcare providers screen patients for depression, a new study found that only 4% of adults were screened for depression during primary care visits.

That low rate suggests missed opportunities to identify patients with depression and link them with care, according to a study by researchers from Rutgers University that was published in Psychiatric Services.

Screening for depression is now recommended as a part of routine primary care by the U.S. Preventive Services Task Force, but rarely occurred in a national sample of 33,653 visits to office-based primary care doctors, the study found.

Diagnosis was particularly low among certain groups. Doctors were half as likely to screen African-American patients compared with whites and half as likely to screen elderly patients compared with middle-aged people.

Doctors were more likely to screen patients with a chronic condition, with the likelihood increasing with each additional health condition. In the visits where screening took place, 47% resulted in a new depression diagnosis, suggesting that doctors screened patients when they suspected the person was depressed.

The study suggested that electronic health record systems may be an effective tool to improve screening rates, as providers who had fully adopted EHRs were more likely to screen for depression than were those who used paper records.

Primary care doctors can play an important role in linking patients with mental health services. "Primary care settings are an opportune location for early identification of depression, as many depressed patients' contact with the healthcare system is through primary care," the study’s lead author, Ayse Akincigil, Ph.D., told Medscape Medical News (reg. req.).

Physicians could do a better job treating patients’ mental health disorders if they had better training to properly diagnose conditions and behavioral health resources to refer patients when they do find a problem.

The American College of Preventive Medicine recommends that primary care doctors routinely screen adults for depression and says it can be as easy as having patients fill out reliable depression screening instruments such as the Beck Depression Inventory and the Patient Health Questionnaire while in the doctor’s waiting room.