Harvard Medical School, Boston, Massachusetts.
George Washington University, Washington, DC.
JAMA. 2023 Jun 20;329(23):2057-2067. doi: 10.1001/jama.2023.9297.
Major depressive disorder (MDD), a common mental disorder in the US, may have substantial impact on the lives of affected individuals. If left untreated, MDD can interfere with daily functioning and can also be associated with an increased risk of cardiovascular events, exacerbation of comorbid conditions, or increased mortality.
The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate benefits and harms of screening, accuracy of screening, and benefits and harms of treatment of MDD and suicide risk in asymptomatic adults that would be applicable to primary care settings.
Asymptomatic adults 19 years or older, including pregnant and postpartum persons. Older adults are defined as those 65 years or older.
The USPSTF concludes with moderate certainty that screening for MDD in adults, including pregnant and postpartum persons and older adults, has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on the benefit and harms of screening for suicide risk in adults, including pregnant and postpartum persons and older adults.
The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons and older adults. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for suicide risk in the adult population, including pregnant and postpartum persons and older adults. (I statement).
重度抑郁症（MDD）是美国常见的精神障碍，可能对受影响个体的生活产生重大影响。如果不进行治疗，MDD 可能会干扰日常功能，并且还可能与心血管事件风险增加、合并症恶化或死亡率增加有关。
美国预防服务工作组（USPSTF）委托进行了一项系统评价，以评估对无症状成年人进行 MDD 和自杀风险筛查、筛查准确性以及治疗的益处和危害，这些将适用于初级保健环境。
19 岁及以上的无症状成年人，包括孕妇和产后人群。老年人的定义为 65 岁或以上的人群。
USPSTF 有中等确定性的结论认为，对成年人（包括孕妇和产后人群以及老年人）进行 MDD 筛查具有中度净收益。USPSTF 得出结论，目前关于在成年人（包括孕妇和产后人群以及老年人）中筛查自杀风险的益处和危害的证据不足。
USPSTF 建议对成年人群体进行抑郁症筛查，包括孕妇和产后人群以及老年人。（B 级推荐）USPSTF 得出结论，目前证据不足以评估在成年人群体（包括孕妇和产后人群以及老年人）中筛查自杀风险的益处和危害的平衡。（I 声明）
