Preventive activities in general practice 7th edition

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Screening tests of unproven benefit

Appendices

Disclaimer

Depression

Depression age range table
Age	0 - 9	10 - 14	15 - 19	20 - 24	25 - 29	30 - 34	35 - 39	40 - 44	45 - 49	50 - 54	55 - 59	60 - 64	65 - 69	70 - 79+
			17	X	X	X	X	X	X	X	X	X	X	X

Depression age range table

Age

0 - 9

10 - 14

15 - 19

20 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 - 69

70 - 79+

There is evidence for opportunistic screening for depression in the general adult population provided there is effective treatment and follow up offered to those found to have depression (B).⁴³⁷ There is insufficient evidence to recommend for or against routine screening in adults where feedback and management are not available; or in children and adolescents. Clinicians should maintain a high level of awareness for depressive symptoms in patients at high risk for depression.

Depression risk
Who is at higher risk for depression?	What should be done?	How often?	Level of evidence and references
Average risk Adult population 18 years of age and over	Screen for depression and offer effective management and follow up if further assessment confirms depression	Opportunistically	I B 437
Adolescents	The benefits of screening have not been established. Be alert for signs of depression in this age group	At every encounter	Insufficient evidence 437,438
Increased risk Those with a past history of depression Aboriginal people and Torres Strait Islanders Those with multiple or unexplained somatic complaints Those with chronic illness/pain, chronic insomnia/fatigue Those with acute cardiovascular events (MI/ stroke) Those who have experienced recent loss/trauma Those abusing alcohol or other drugs Comorbid psychological conditions (eg. panic disorder or generalised anxiety) or other psychiatric disorders Postpartum women Those with poor social supports Un/underemployed people Young men living in rural areas Mothers from low SES groups Those suffering from life stress including refugees and recent migrants	Screen for depression and offer effective management and follow up if further assessment confirms depression Maintain a high level of clinical awareness of those at high risk of depression	Opportunistically	III C 437,439,440

Depression risk

Who is at higher risk for depression?

What should be done?

How often?

Level of evidence and references

Average risk

Adult population 18 years of age and over

Screen for depression and offer effective management and follow up if further assessment confirms depression

Opportunistically

I B 437

Adolescents

The benefits of screening have not been established. Be alert for signs of depression in this age group

At every encounter

Insufficient
evidence 437,438

Increased risk

Those with a past history of depression
Aboriginal people and Torres Strait Islanders
Those with multiple or unexplained somatic complaints
Those with chronic illness/pain, chronic insomnia/fatigue
Those with acute cardiovascular events (MI/ stroke)
Those who have experienced recent loss/trauma
Those abusing alcohol or other drugs
Comorbid psychological conditions (eg. panic disorder or generalised anxiety) or other psychiatric disorders
Postpartum women
Those with poor social supports
Un/underemployed people
Young men living in rural areas
Mothers from low SES groups
Those suffering from life stress including refugees and recent migrants

Screen for depression and offer effective management and follow up if further assessment confirms depression

Maintain a high level of clinical awareness of those at high risk of depression

Opportunistically

III C 437,439,440

Test	Technique	Level of evidence and reference
Question regarding mood and anhedonia	Asking two simple questions may be as effective as longer instruments: ‘Over the past 2 weeks, have you felt down, depressed or hopeless?’, and ‘Over the past 2 weeks have you felt little interest or pleasure in doing things?’ Asking a patient if help is needed in addition to these two screening questions improves the specificity of a diagnosis of depression	IV 441

Test

Technique

Level of evidence and reference

Question regarding mood and anhedonia

Asking two simple questions may be as effective as longer instruments:

‘Over the past 2 weeks, have you felt down, depressed or hopeless?’, and
‘Over the past 2 weeks have you felt little interest or pleasure in doing things?’

Asking a patient if help is needed in addition to these two screening questions improves the specificity of a diagnosis of depression

IV 441

Guidelines for preventive activities in general practice 7th edition

Full index

Introduction and user guide

Preventive activities before pregnancy

Genetic counselling and testing

Preventive activities in children and young people

Preventive activities in middle age

Preventive activities in older age

Communicable diseases

Prevention of chronic disease

Prevention of vascular and metabolic disease

Early detection of cancers

Psychosocial

Oral hygiene

Glaucoma

Urinary incontinence

Osteoporosis

Screening tests of unproven benefit

References

Appendices

Glossary

Acronyms

Acknowledgements

Disclaimer

Depression