According to the results of a recent study, general practitioners are not screening enough of their high risk patients for depression. The study, led by Bhautesh Dinesh Jani of the Institute of Health and Wellbeing at the University of Glasgow in Scotland was designed to determine how often individuals with chronic illness are screened for depression in general practice settings. Individuals with chronic illnesses have a high risk of developing depression and other mood issues.
Therefore, efforts to provide early identification and treatment of those at risk have been stepped up throughout the United Kingdom and across the globe. In Scotland, primary care doctors are encouraged to screen people with chronic illnesses for depression. But Jani wanted to find out if they were doing that, and if so, what was being down as a result of the screening.
Jani analyzed data from over 125,000 patients with any combination of diabetes, coronary heart disease, or stroke that saw their primary care doctor between 2008 and 2009. The data was examined for presence of a screening, level of symptoms and treatment outcome. Jani found that even though this early detection system has been encouraged, nearly 69% of all patients had no record of ever being screened for depression. It is unknown whether stigma, shame, or other barriers prevented this from occurring, but these factors should be looked at more closely.
Of all the patients in the study, 8.5% had already been diagnosed with depression. Out of the remaining group, 19.9% had elevated depressed symptoms that indicated a potential for mild depression. After six months, 8% of those with elevated depressed symptoms began antidepressant medication, and 2.4% with normal depression scores and no indication of depressed mood also started antidepressants. Although some research suggests that males are prescribed antidepressants more often than females, these results demonstrated just the opposite. In fact, middle aged females between the ages of 45 and 64 were most likely to be prescribed antidepressants.
In general, depressed mood and elevated depression scores were found in females more than males, in those with low incomes, in those under the age of 44, and in those with multimorbid conditions. Jani believes that this research shows that early screening and detection changes the course of routine treatment for chronically ill patients. “The key question will be to explore how such treatment changes affect outcomes, if at all,” said Jani.
Jani, B.D., Purves, D., Barry, S., Cavanagh, J., McLean, G., et al. (2013). Challenges and implications of routine depression screening for depression in chronic disease and multimorbidity: A cross-sectional study. PLoS ONE 8(9): e74610. doi:10.1371/journal.pone.0074610
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