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Book and Media Reviews
May 19, 2010

Screening for Depression in Clinical Practice: An Evidence-Based Guide

JAMA. 2010;303(19):1980-1985. doi:10.1001/jama.2010.627

This book comes across as a breath of fresh air, although it takes a while to discern from which direction the wind is blowing. Its intent is to enhance and facilitate the accurate diagnosis and treatment of depression, particularly by primary care practitioners, since they are far more likely to see depressed patients first than are scarcer specialists.

The book starts out by asking a series of questions that seem almost simple-minded but that on further explication turn out to be anything but; eg, “What is depression?” “Is it a valid concept?” “How do we know when diagnoses are accurate?” “How do we know when a screening tool or test for depression is clinically useful?” “Can written instruments substitute effectively for standardized or semistructured clinical interviews?” “Do the settings in which screening takes place influence clinical decisions?” “Are sufficient distinctions made between major and minor depressions, which can have quite different symptoms and courses?” The answers are fascinating and instructive, and when the authors cannot find good documentation for an answer, they say so.