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By Nerys Hairon

GPs should resist pressure to screen for depression as it has only 'minimal impact', a gold standard review concludes.

The Cochrane review found 'substantial evidence' that depression screening had little if any effect on detection and management of depression, or patient outcomes.

The researchers urged NICE to review its guidance, released in December last year, which recommends screening for at-risk patients. They warned it was likely enhanced services for depression were being based on 'possibly ineffective screening strategies'.

Study leader Dr Simon Gilbody, senior lecturer in mental health services research at Hull-York medical school, said: 'Screening each and every patient in primary care with standardised questionnaires is a costly and intrusive exercise, and there is little evidence to support it.

'We found the evidence does not show screening helps doctors pick up the depression we know they miss or improves the management of depression or, most importantly, improves patient outcomes.'

The review was of 12 studies, based on 5,693 patients.

Three out of four studies reported no effect on outcomes at six months or 12 months.

The researchers also found no evidence to support the

use of screening at-risk patients.

Dr Harry Yoxall, medical secretary of Somerset LMC, said around half of GPs used some form of depression screening, but the new results might provoke a rethink.

But mental health experts reacted cautiously to the review.

Professor Tony Kendrick, a researcher on depression treatment and professor of primary medical care at the University of Southampton, said: 'These authors say there's no re-

search to support screening in high-risk groups, but there's none saying it's a bad thing

either.'

Dr Alan Cohen, RCGP spok-esman on mental health and a GP in south London, said: 'The pragmatic thing is to screen at-risk groups, even though there is no evidence.'

The researchers said the NHS should focus on strategies to improve co-ordination of care for depression, not screening.

nhairon@cmpinformation.com

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