Screening for depression at primary level could be next trend in healthcare

COLLEGE STATION, Sept. 16, 2003 Given that one out of three patients seen by a primary physician suffers from a mental disorder, administering a simple screening measure at this level is not only effective, it's needed, says a Texas A&M University psychologist.

"It is clear that mental health diagnosis and treatment must become more fully integrated into the primary care system," says psychologist Mary Meager, who has been testing the effectiveness of a screen at the primary care level.

Working with Rachel Bramson, a family medicine physician on the faculty at Texas A&M's medical school and on the staff of Scott & White, along with colleagues from the University of California San Diego and the University of Southern Mississippi, Meagher studied 591 patients ranging in age from 18 to 86.

She says a brief, self-administered screening tool consisting of five questions can efficiently and effectively screen for depression and panic disorders among primary health care patients.

The tool, known as the Mental Health Index-5 (MHI-5), is a condensed version of the larger Mental Health Inventory and was developed for use in the general population. Meagher says the MHI-5 can distinguish patients with a psychiatric condition from those without a psychiatric condition and from those with a medical condition. It measures anxiety, depression, loss of behavioral or emotional control, and psychological well-being.

"The MHI-5 meets the criteria of utility and efficiency, and its adoption in clinical practice would be the first, and perhaps most important, step toward improving outcomes for distressed primary care patients," Meagher says.

Based on the results of her research, Meagher found that the overall accuracy of this screening measure in detecting major depression or panic disorder was 82.1 percent. In other words, of all the people identified as possibly suffering from these disorders, about eight out of every 10 actually were

Contact: Ryan A. Garcia
Texas A&M University

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