Screening for Depression Does Not Improve Outcomes, Even with Targeted Feedback

A study involving over 8,000 patients challenges the effectiveness of depression screening in primary care settings.

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Although screening for depression in primary care is recommended by US guidelines, there is no direct evidence that it improves outcomes. For that reason, guidelines in other countries, such as Canada, Germany, and the UK, don’t recommend screening.

One argument is that screening alone is not enough—in order to improve outcomes for any health condition, people who screen positive need to receive follow-up care that betters their condition.

To test whether this is possible for depression, a new study in Lancet Psychiatry examined whether screening plus providing targeted feedback to patients and general practitioners (GPs) could improve outcomes. However, the researchers found that it did not.

“Providing targeted feedback to patients and GPs after depression screening does not significantly reduce depression severity compared with GP feedback alone or no feedback,” the researchers write.

The study was conducted by 24 German researchers, led by Bernd Löwe, Martin Scherer, Marco Lehmann, and Sebastian Kohlmann at the University Medical Centre Hamburg-Eppendorf.

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9 COMMENTS

  1. Not surprising, to me at least. I always feel a certain queasy unwillingness to share anything at all about my mental/emotional well-being when asked about it as part of a routine check-in for a medical appointment at the ENT clinic. WTF has the ENT clinic got to do with my emotional well-being? Certainly, the sullen, angry-looking male nurse who always checks me in isn’t exactly a warm, inviting presence to share my intimate emotional state with. I think it has a lot more to do with data collection than with my emotional health. And that pisses me off. Which has a negative effect on my emotional well-being. Which is what I want to tell the angry nurse, but never do.

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    • I feel the same way. A person’s emotional state is highly personal, therefore is someone’s personal property, something a stranger has no business knowing or asking about for any reason whatsoever. I don’t care who they are or what their purpose is.

      It’s one of many micro-inequities perpetrated by the ‘mental health system’ that leaves a bad taste in my mouth.

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  2. The PHQ9 has got to be one of the most dangerous tick box questionnaires ever deployed – it inflates several fold the likelihood you will be labelled ‘depressed’ or ‘GAD’ – not surprising considering it was the brain child of a marketing man called Howard Kroplick employed by Pfizer. Tasked with the job of expanding drug prescribing by creating something primary care GP’s could administer in a brief entirely insufficient consultation. The idea was then taken up by Spitzer based on his ‘criteria’ for ‘depression’. When asked by James Davies in his book cracked why this many ‘symptoms’ and not say more or less – Spitzer replied stating that more more just seemed like too many and less too few – ZERO science and has led to millions of people being prescribed with ZERO informed consent drugs marketed as ‘antidepressants’ they no longer need, benefit from and are often harmed by.

    The term ‘antidepressant’ was minted once drug companies realised they had a market for their new drug if only they could expand this market via well funded campaigns like defeat depression etc. The regulator granted the use of the term after just two crap studies showing a non statistically significant reduction on another tick box the Ham D.

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  3. WTF is ‘screening for depression’??? Stupid checklists produced by pharmaceutical companies administered by equally stupid people looking to rope in new ‘clients’?

    All these do is prove one thing: psychiatry is the apex of capitalism.

    Duplicate [comment]

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  4. WTF is ‘screening for depression’??? Stupid checklists bankrolled by pharmaceutical companies administered by stupid people looking for more ‘clients’.

    It does prove one thing, however: psychiatry is the apex of capitalism.

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  5. “Researchers have reported concerns that screening can lead to overdiagnosis and overtreatment and wastes the time and resources of both doctors and patients. In a study that found screening youth for depression led to more severe outcomes, the researchers note that screening may have an iatrogenic affect—worsening depression by making people focus on it.”

    Bingo! This is the reason why the number of people being diagnosed with ‘mental illness’ has exploded, to the dertriment of themselves and society.

    I had serious misgivings when I first heard of widespread screenings for ‘depression’ some thirty-odd years ago. I found myself hoping some influential person in psychiatry would come forward and issue warnings about what this could lead to: a massive iatrogenic effect. But instead what I feared would happen did happen, which is especiallly tragic for people too young and inexperienced to recognize the dynamics of situations like this; in other words, how their emotions are being used (pathologized) to promote The Sickness Industry more than anything else.

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  6. This is a clear case of “professionals” not knowing what they are doing.

    “Depression” has got to be one of the most over-diagnosed (8.3% of all U.S. adults, 2021) and least understood “disorders” in that big fat list that the psychs use.

    There is also a popular pressure – at least from some cultures – for a “quick fix so I can get back to work.”

    Of all the possible mental conditions, this – properly understood – should be the least of our concerns. Most people recover and get on with their lives. About 75% of people with the diagnosis of “major depressive episode” recover completely.

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