Intended for healthcare professionals


Screening for depression and anxiety in general practice

BMJ 2023; 382 doi: (Published 17 July 2023) Cite this as: BMJ 2023;382:p1615
  1. Brett D Thombs, Canada research chair1,
  2. Sarah Markham, visiting researcher2,
  3. Danielle B Rice, assistant professor3,
  4. Roy C Ziegelstein, professor4
  1. 1Lady Davis Institute for Medical Research of the Jewish General Hospital and McGill University, Montréal, Québec, Canada
  2. 2Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, UK (patient author)
  3. 3McMaster University, Hamilton, Ontario, Canada
  4. 4Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to: B Thombs brett.thombs{at}

New US screening recommendations will expose patients to unnecessary harm

The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice.12 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment.3

Decisions to initiate screening programmes should be based on high quality evidence of sufficient benefits to justify the harms that might be experienced by those who are screened and the consumption of resources that would be unavailable for other healthcare services.4 An effective mental health screening programme would require that patients agree to be screened; receive a screening test; get an accurate diagnosis if they have a positive result; and can then access treatments they agree to undertake. Furthermore, treatments must reduce symptoms more than no treatment, which may not be the case for people with mild or transient symptoms detected through screening.3

The USPSTF said that it considered 17 …

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