Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Depression Screening by Alcohol Use Severity

J Am Board Fam Med; 2018 Sep-Oct; Hirschtritt, et al

Only a small fraction of primary care adult patients with depression and severe alcohol use were screened for depression, a recent study found. Using cross-sectional data from primary care patients (n=2,894,906), researchers examined past-90-day alcohol use, depression screening rates, and symptom severity. They found:

  • Within 30 days of routine, in-clinic alcohol use screening by medical assistants, only 2.4% of patients (n=68,686) also competed a PHQ-9 (screening rates).
  • Nonwhite patients and those with higher comorbidity were more likely to report depression but less likely to be screened.
  • Abstainers and moderate drinkers were less likely than hazardous drinkers to complete the PHQ-9 or to have significant depressive symptoms.
  • The discrepancies between depression-screening rates and significant depressive symptoms suggest that screening for depression should be enhanced in these at-risk groups.


Hirschtritt ME, Kline-Simon AH, Kroenke K, Sterling SA. Depression screening rates and symptom severity by alcohol use among primary care adult patients. J Am Board Fam Med. 2018;31(5):667-670. doi:10.3122/jabfm.2018.05.180092.