Am J Psychiatry 1997; 154:1391-1397
Copyright © 1997 by American Psychiatric Association
Effectiveness of community-based screening for depression
SF Greenfield, JM Reizes, KM Magruder, LR Muenz, B Kopans and DG Jacobs
University of Pennsylvania, Philadelphia, USA.
OBJECTIVE: The effectiveness of a voluntary depression screening program
was assessed by determining 1) whether participants in the 1994 National
Depression Screening Day went for recommended follow-up examinations and 2)
the characteristics that differentiated those who did and did not return.
METHOD: Randomly selected participants (N = 1,169) from 99 facilities
completed a follow-up telephone survey. RESULTS: Of 805 people for whom
follow-up was recommended, 56.5% (N = 455) went for an appointment. The
severity of depressive symptoms in these subjects ranged from severe
(33.4%, N = 152) and marked (41.3%, N = 188) to minimal (17.1%, N = 78) and
normal (8.1%, N = 37). Subjects with marked or severe depression were more
likely to respond to the screening recommendation than were those with
minimal depressive symptoms. However, at each level of symptom severity,
subjects who had received previous treatment were more likely to adhere to
the screening recommendation than were those with no previous treatment. Of
those who returned for a recommended follow-up, 72.1% were diagnosed with
depression. Of those who did not return, 29.5% cited lack of insurance,
under insurance, or inadequate finances, and 38.0% felt they could "handle"
depression on their own. CONCLUSIONS: Voluntary screening for depression is
an effective way to bring certain untreated depressed individuals to
treatment. Inadequate insurance and the belief that individuals can manage
depression on their own continue to be barriers to seeking treatment among
some depressed individuals who attend a depression screening program.
