Depression is a leading cause of disability worldwide, affecting an estimated 280 million people globally.1 It can have a profound impact on multiple aspects of a patient’s life, including physical health, quality of life, and the ability to effectively function at school, work, or with family.1,2 During pregnancy, approximately 20% of women were not asked about depression during a prenatal visit, even though one in eight women report symptoms of depression after giving birth.3 One survey of US adults indicated that 19.2% of adults experienced the symptoms of at least one episode of major depression during their lifetime, yet 42.3% of patients with symptoms of major depression in the last 12 months did not receive any treatment for their emotional health.4
Early Detection of Depression in Adults May Help Address Overall Wellbeing Sooner
A diagnosis of depression in adults has a negative impact not only on the patient themselves, but also on their family, social circle, and employer as well as on the overall health care and economic system.2 Women experiencing depression during pregnancy demonstrate an increased risk of preterm delivery, postpartum depression, and development of behavioral problems in their children.5 Patients with depression tend to have multiple comorbidities, and it is estimated that the direct and indirect costs of depression totaled $210 billion in 2010 ($236 billion in year 2020 values) and have increased to $326 billion in 2018 (year 2020 values).6 Societal costs of depression include reduced educational achievement, poorer financial success, higher number of days out of work, and increased risk of job loss.7
Several studies have demonstrated that early identification and treatment of depression, using standardized questionnaires given by health care providers, can improve the negative aspects of the disorder.2,8,9 Routine depression screening can be used to improve the recognition of depressive episodes. Because depression is a disorder that still has a negative stigma in many cultures, the administration of a questionnaire might help decrease this stigma by giving patients a clear description of the main features of depressive disorders and help patients discover aspects of the illness they may have never known. This would help patients and their caregivers recognize symptoms in themselves and others.10 Newer research is even identifying methods by which machine learning on social networks may help with early detection of depression.11
Early Detection of Depression in Adolescents May Prevent Additional Declines in Mental Health
Adolescence is an important time for youth to develop their knowledge and skills and to learn how to manage relationships and emotions in preparation for adulthood.12 Depression in adolescence is a major risk factor for suicide and can also lead to increased social, emotional, and educational disruption.12 Recent studies published by the Centers for Disease Control and Prevention (CDC) indicate that 21% of teens experienced a major depressive episode before the pandemic.13 The pandemic has only exacerbated this issue, with a recent CDC survey of teens during the pandemic finding that 44% of teens said they felt persistently sad or hopeless during the past 12 months.14 Considering these alarming trends, the American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association have declared a national emergency in children’s mental health.15
Timely identification of depressive symptoms in adolescents is critical, due to the recurrent nature of the disorder and its association with poor academic performance, functional impairment, increased risk of suicide, and negative impact on relationships with parents, siblings, and peers.12 The AAP recommends that all children ages 12 and over be screened by their pediatrician annually for depression as well as suicide risk.16 The goal is to facilitate early identification of depression, initiate treatment, and refer to mental health specialists as needed. The hope is that regular screening by primary care providers will identify at-risk adolescents early to address and avoid some of the long-term consequences of depression that can affect their entire lives.
Regardless of a patient’s age, early detection, intervention, and appropriate treatment can promote remission, prevent relapse, and reduce the emotional and financial burden of the disease, with the goal of a positive impact on both the quantity and quality of life.
- World Health Organization. Fact Sheet on Depression. September 13, 2021. Accessed September 7, 2022. https://www.who.int/news-room/fact-sheets/detail/depression
- Halfin A. Depression: the benefits of early and appropriate treatment. Am J Manag Care. 2007;13(4 Suppl):S92-S97.
- Centers for Disease Control. Identifying Maternal Depression. Accessed September 27, 2022. https://www.cdc.gov/reproductivehealth/vital-signs/identifying-maternal-depression/index.html
- Kessler RC, Birnbaum H, Bromet E, Hwang I, Sampson N, Shahly V. Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med. 2010;40(2):225-237. doi:10.1017/S0033291709990213
- Safi-Keykaleh M, Aliakbari F, Safarpour H, et al. Prevalence of postpartum depression in women amid the COVID-19 pandemic: A systematic review and meta-analysis. Int J Gynaecol Obstet. 2022;157(2):240-247. doi:10.1002/ijgo.14129
- Greenberg PE, Fournier AA, Sisitsky T, et al. The economic burden of adults with major depressive disorder in the United States (2010 and 2018). Pharmacoeconomics. 2021;39(6):653-665. doi:10.1007/s40273-021-01019-4
- Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-138. doi:10.1146/annurev-publhealth-031912-114409
- Picardi A, Lega I, Tarsitani L, et al. A randomised controlled trial of the effectiveness of a program for early detection and treatment of depression in primary care. J Affect Disord. 2016;198:96–101. doi:10.1016/j.jad.2016.03.025
- Rost K, Smith JL, Dickinson M. The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial. Med Care. 2004;42(12):1202–1210. doi: 10.1097/00005650-200412000-00007
- Costantini L, Costanza A, Odone A, et al. A breakthrough in research on depression screening: from validation to efficacy studies. Acta Biomed. 2021;92(3):e2021215. doi: 10.23750/abm.v92i3.11574
- Cacheda F, Fernandez D, Novoa FJ, Carneiro V. Early detection of depression: social network analysis and random forest techniques. J Med Internet Res. 2019;21(6):e12554. doi: 10.2196/12554
- Beirão D, Monte H, Amaral M, et al. Depression in adolescence: a review. Middle East Curr Psychiatry. 2020;27(50):1-9. doi:10.1186/s43045-020-00050-z
- Bitsko RH, Claussen AH, Lichstein J, et al. Mental health surveillance among children – United States, 2013-2019. MMWR Suppl. 2022;71(2):1-42. doi:10.15585/mmwr.su7102a1
- Jones SE, Ethier KA, Hertz M, et al. Mental Health, Suicidality, and Connectedness Among High School Students During the COVID-19 Pandemic – Adolescent Behaviors and Experiences Survey, United States, January-June 2021. MMWR Suppl. 2022;71(3):16-21. doi: 10.15585/mmwr.su7103a3
- American Academy of Pediatrics. AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health. Updated October 19, 2021. Accessed September 7, 2022. https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health
- 2022 Recommendations for Preventive Pediatric Health Care. Pediatrics. 2022;150(1):e2022058044. doi:10.1542/peds.2022-058044