Does depression screening have an effect on the diagnosis and treatment of mood disorders in general medical settings? an instrumental variable analysis of the national ambulatory medical care survey

Research output: Contribution to journalArticle

Abstract

This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.

Original languageEnglish (US)
Pages (from-to)462-489
Number of pages28
JournalMedical Care Research and Review
Volume68
Issue number4
DOIs
StatePublished - Aug 2011

Fingerprint

Health Care Surveys
Mood Disorders
Antidepressive Agents
Depression
Prescriptions
Therapeutics
Physicians' Offices
Physicians

Keywords

  • antidepressants
  • depression
  • depression screening
  • depression treatment

ASJC Scopus subject areas

  • Health Policy

Cite this

@article{6c7f685b4289414c8a1956da07543cad,
title = "Does depression screening have an effect on the diagnosis and treatment of mood disorders in general medical settings? an instrumental variable analysis of the national ambulatory medical care survey",
abstract = "This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4{\%} of the screened visits compared with 16.3{\%} of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.",
keywords = "antidepressants, depression, depression screening, depression treatment",
author = "Ramin Mojtabai",
year = "2011",
month = "8",
doi = "10.1177/1077558710388290",
language = "English (US)",
volume = "68",
pages = "462--489",
journal = "Medical Care Research and Review",
issn = "1077-5587",
publisher = "SAGE Publications Inc.",
number = "4",

}

TY - JOUR

T1 - Does depression screening have an effect on the diagnosis and treatment of mood disorders in general medical settings? an instrumental variable analysis of the national ambulatory medical care survey

AU - Mojtabai, Ramin

PY - 2011/8

Y1 - 2011/8

N2 - This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.

AB - This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.

KW - antidepressants

KW - depression

KW - depression screening

KW - depression treatment

UR - http://www.scopus.com/inward/record.url?scp=80051528873&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051528873&partnerID=8YFLogxK

U2 - 10.1177/1077558710388290

DO - 10.1177/1077558710388290

M3 - Article

C2 - 21454246

AN - SCOPUS:80051528873

VL - 68

SP - 462

EP - 489

JO - Medical Care Research and Review

JF - Medical Care Research and Review

SN - 1077-5587

IS - 4

ER -