Screening for depression among women attending their family physicians.

Abstract
Two studies were conducted to investigate the utility of a screening instrument for the detection of major depressive disorders among women attending their family physicians. In Study 1, it was found that a cut-off score of 13 on the Center for Epidemiologic Studies Depression (CES-D) scale resulted in zero false negatives among 437 women attending their family doctors when a classification (i.e., depressed vs. non-depressed), based on total CES-D scores, was compared with a classification of these women on the basis on DSM-III criteria. In Study 2, a screening instrument for depression was tested among 679 women attending their family doctors and whose score on the CES-D was 13 or higher. The screening instrument consisted of the CES-D items plus items measuring variables that previous research had found to be associated with depression, including recent stressful life events and chronic difficulties, social supports, and personal and family history of psychiatric disorder. The inclusion of additional screening items did not meaningfully improve the detection of depressed individuals beyond the level provided by total scores on the CES-D. Suggestions are made concerning the direction of future research on screening for depression in the offices of family physicians.