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USPSTF 2022: Screening for major depressive disorder recommended in adolescents aged 12 to 18 years (B recommendation)
Clinical Question
What are the benefits and harms of screening for major depressive disorder and suicide risk in children and adolescents?
Bottom line
The USPSTF recommends screening for MDD in adolescents aged 12 to 18 years (B recommendation). The most commonly used screening tool, the Patient Health Questionnaire-9 (PHQ-9) tool, recently was shown to have a false positive rate of 77% for adults screened in primary care. The task force was unable to identify any studies that evaluated the use of the PHQ-9 in children and adolescents. The task force also concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for MDD in children 11 years or younger (I statement). Similarly, current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in children and adolescents (I statement). These recommendations are consistent with the 2014 and 2016 USPSTF recommendations. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Various (guideline)
Synopsis
This updated US Preventive Services Task Force (USPSTF) review of the available evidence found that screening can accurately identify major depressive disorder (MDD) in adolescents aged 12 to 18 years. Treatment of MDD with psychotherapy and/or pharmacotherapy can improve depressive symptoms. However, no studies reported on overall health benefits of screening versus not screening. The evidence was limited regarding the evaluation of screening instruments and interventions for suicide risk. Screening for MDD is also recommended by the American Academy of Pediatrics and the American Psychiatric Association.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
No
No
Screening for adolescents
Should be done routinely
MDD in teens - screening
I use PHQ-9 often when screening teens for MDD. It is a surprise to me the there is such a high degree of false positives. Will research if there is better way of screening for MDD.
should help sales of pharmaceuticals
Likely help sell lots of unnecessary prescribing
what instruments are recommended?
If PHQ9 has a 77% false positive rate in adults and there is insufficient evidence to evaluate its use in younger people, what instruments are recommended?
Not clear
The body of this post seems to contradict the title . Am I misunderstanding this ?