Screen all for depression

Major depressive disorder is a ubiquitous and often devastating condition. It accounts for 2.5% of disability adjusted life years worldwide1 and is the most common mental illness in people who die from suicide.2 In January 2016, the United States Preventive Services Task Force issued updated recommendations calling for universal screening of adults for depression. This was based on its systematic review of five trials with a total of 2924 participants that examined screening in general adult populations.3 The task force concluded that “treatment of adults and older adults with depression identified through screening in primary care settings with antidepressants, psychotherapy, or both decreases clinical morbidity” and that the benefits of screening outweighed its harms.3 This recommendation goes further than those from countries such as the United Kingdom and Canada, where guidelines suggest that clinicians be alert to possible depression, particularly in …