Screening

Persistent depressive disorder is a mood disorder that is often under-diagnosed. Screening for depression in clinical populations is best achieved using depression self-rating scales, such as the Patient Health Questionnaire, the Beck Depression Inventory, and the Quick Inventory of Depressive Symptoms.[34][35][36]

Alternatively, an inquiry could be made regarding the patient's mood, such as "Have you been depressed?" When depression is present, duration should be ascertained - in particular, whether greater than 2 years.

Concomitantly in clinical settings, it is important to screen for other psychiatric disorders, such as bipolar disorder, obsessive compulsive disorder, anxiety disorders and, substance use disorders.

US screening recommendations

The US Preventive Services Task Force (USPSTF) recommends screening for depression in the adult population, including pregnant and postpartum people, as well as older adults.[37]

In children, universal screening for depression in a primary care setting is recommended for all ages 12 years and older, even in the absence of specific risk factors, according to the USPSTF.[38]​​[39]​ At present, the USPSTF does not recommend screening for depression in children ages 11 years or younger, based on insufficient evidence of net benefit. However, note that in children in this age group, early identification can facilitate early intervention.[40]​

UK screening recommendations

The National Institute for Health and Care Excellence (NICE) suggests screening for depression in those with suggestive symptoms and signs, particularly people with a past history of depression or a chronic physical health problem with associated functional impairment.[41] ​NICE recommend asking the following two initial questions to guide the need for a more comprehensive mental health assessment, possibly in conjunction with a validated screening tool:[41]

  • During the last month, have you often been bothered by feeling down, depressed, or hopeless?

  • During the last month, have you often been bothered by having little interest or pleasure in doing things?

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