Routine depression screening by primary care physicians may capture under-diagnosed patient populations

A study led by University of California – San Francisco found that screening for depression at the primary care level could dramatically increase the likelihood of treatment for those who are traditionally under-treated: racial and ethnic minorities, older adults, those with limited English proficiency, and men. The study was published in Jama Network Open.

Depression goes unrecognized in more than half of patients with symptoms in primary care. An estimated 60% of patients receive depression care at the primary care level.

The researchers looked at the data of almost 53,000 patients over a two-year period. After a routine screening policy was implemented at six UCSF primary care facilities, depression screening rates more than doubled, from 40.5% in 2017 to 88.8% in 2019.

According to the study, in 2018, researchers found that for every 100 patients ages 18 to 30 screened for depression, 75 patients ages 75 and older were likely to be screened for depression. For every 100 English-speaking white patients screened for depression, there were 59 Chinese-language patients and 55 other non-English language patients likely to be screened for depression. By 2019, disparities for older, Black, and those with language barriers, all but disappeared. Screening for men remained lower than that for women, where for every 100 women screened for depression, 87 men were likely to be screened. Prior to the policy change, it was 82 men.

The researchers noted that because depression affects other chronic diseases, routing depression screening could improve outcomes for complications from other conditions. They also noted that during the study period, depression screening was part of a larger focus across the state and had state funding to help primary care practices get the resources they needed.