What is the USPSTF stance on depression screening?

• A. Screen for major depressive disorder in adults 18+ with systems in place for diagnosis and treatment.
• B. Do not screen for depression due to potential harms.
• C. Screen only adolescents under 18.
• D. Screen all patients annually for depression with no follow-up.

Answer: (A)

Screening for major depressive disorder in adults 18 years and older is recommended, but only when there are adequate systems in place for diagnosis, treatment, and follow-up. The idea is not to screen in isolation—identifying someone with depressive symptoms must be followed by proper assessment, access to evidence-based treatment, and ongoing monitoring. When these supporting options exist, the net benefit of screening is positive because it helps people get help earlier and reduces the overall burden of illness.

Why this is the best fit: The statement emphasizes both identifying depression and ensuring there is a pathway to care. Without diagnosing capability, effective treatment options, and follow-up, screening alone can cause more harm than good (false positives, unnecessary anxiety, or untreated cases). The other options misstate the guideline: screening is not limited to adolescents, it is not recommended to screen everyone annually with no follow-up, and there is not a blanket prohibition on screening.