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Ivanhoe Newswire – September 21, 2011
If you’re feeling down, don’t rush to your doctor just yet. Many instances of mild depression resolve without intervention. In fact, a new analysis published in the Canadian Medical Association Journal (CMAJ) concludes that routine screening for depression isn’t beneficial or efficient.
The United States and Canada recommend screening for depression by primary care providers, but the United Kingdom says no way! The UK does not recommend screening because of a lack of evidence and ineffective use of scarce health care resources.
In addition, The UK’s National Institute for Health and Clinical Excellence guidelines, cite concerns about high rates of false-positive results (in some cases more than 50 percent), lack of evidence, high costs and resources, and the diversion of resources away from people with serious depression.
“The prevalence of depression and the availability of easy-to-use screening instruments make it tempting to endorse widespread screening for the disease,” writes Dr. Brett Thombs, Senior Investigator, Lady Davis Institute for Medical Research, Jewish General Hospital, with coauthors.
Screening for depression involves the use of questionnaires, concerning the symptoms of depression, to identify patients who may have depression but have not sought treatment
“However, screening in primary care is a resource-intensive endeavor, does not yet show evidence of benefit, and would have unintended negative effects for some patients,” Dr. Brett writes.
One of the effects can be seen in the high prescription rates for antidepressant medication. In a 2005 study from Canada, seven percent of a sample from the general public reported current use of anti-depressant medication, a figure well above the estimated four percent who actually suffer major depression.
Another negative effect is the potential “nocebo effect”. The opposite of a placebo effect, this occurs when patients, who are not concerned about their mental health, are told they have depression. This can lead to the development or worsening of symptoms.
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