Researchers’ doubts over screening for depression

Screening for depression may soon become health policy in England and Wales but it is unlikely to be effective in improving people’s mental wellbeing, researchers have warned.

A team, headed by academics at the University of York, said that though primary care doctors are rewarded for screening under their new contract, it failed to meet criteria set by the UK National Screening Committee.Depression is a major public health problem, but the research team found that screening criteria on test performance, acceptability, and treatment benefits were not met.The research published in the British Medical Journal concluded that it was doubtful that the benefit from screening would outweigh the harm, and that the screening programme should be cost effective.Researchers found that neither opportunistic screening nor population level screening for depression fulfil the criteria of the National Screening Committee, even though the assumption has been made that screening should be recommended.The research was headed by Dr Simon Gilbody, a Senior Lecturer in Mental Health Services Research at the University of York and the Hull York Medical School (HYMS), and involved Professor Trevor Sheldon, of the Department of Health Sciences. They worked with Professor Simon Wessely, Professor of Psychiatric Epidemiology at the Institute of Psychiatry, King’s College London.Dr Gilbody said: “Screening for depression is an unhelpful diversion from more fundamental questions about the most efficient and effective way of organising and delivering care.””Screening should only be considered as part of a package of enhanced care. Without this, moves to implement screening will be associated with increased costs and no benefit,” Professor Sheldon added.(Source: British Medical Journal: The University of York’s Department of Health Sciences: May 2006.)