Screening of depression in relationship to subsequent patient and physician behavior.

When internal medicine clinic patients were prescreened for depression and this information was fed back to their physicians, significant effects could be noted on the medical records. On the initial visit, prescreening and previsit feedback about depression increased its notation in the medical record by three times, and among depressed patients, resulted in significantly fewer laboratory tests being orders (X = 2.85 vs. 8.12 for depressed patients with feedback after). During the following year, record notations about depression were more likely to be made for those depressed patients that initially were in the "feedback before" group. These patients also saw twice as many providers, made three times as many visits, had three times as any tests ordered, and twice as many medications prescribed as those depressed patients in the "feedback after" group. These findings demonstrate that simple prescreening and feedback techniques may have significant and persistent influences on several dimensions of patient and physician behavior.