Psychotherapy and Antidepressant Use After the US Preventive Services Task Force–Recommended Depression Screening

Abstract

Importance Fewer than one-third of adults with depression receive any treatment for depression. It is important to evaluate the association between the 2016 US Preventive Services Task Force (USPSTF) recommendation and depression treatment nationally. Objective To examine changes in the likelihood of psychotherapy and antidepressant use after the USPSTF-recommended routine adult depression screening. Design, Setting, and Participants This policy evaluation used a single-group, interrupted time series design with logistic regression. Medical Expenditure Panel Survey Household Component data from 2008 to 2023 were analyzed from November 3, 2025, to March 31, 2026. The sample included adults aged 18 years and older. Exposure 2016 USPSTF grade B recommendation for routine adult depression screening. Main Outcomes and Measures Likelihood of psychotherapy or antidepressant use immediately (level change) and over time (post-USPSTF slope change [trend]) using an interrupted time series design and logistic regression models. Results The analysis included 372 962 adults. Using the Medical Expenditure Panel Survey person-level survey weights, this corresponded to a nationally representative sample of 244 316 623 adults (median age, 47 years; IQR, 32-61 years; 51.6% female). The recommendation was associated with a significant level increase (odds ratio [OR], 1.18; 95% CI, 1.02-1.37) and post-USPSTF trend (OR, 1.08; 95% CI, 1.04-1.11) increase in the likelihood of psychotherapy only, level (OR, 0.88; 95% CI, 0.82-0.94) and post-USPSTF trend (OR, 0.98; 95% CI, 0.96-0.99) decreases in the likelihood of antidepressants only, and no significant changes in combined treatment among adults overall. By psychological distress level, it was associated with a significant level increase in the likelihood of psychotherapy only (OR, 1.63; 95% CI, 1.10-2.41) and post-USPSTF trend decrease in the likelihood of antidepressants only (OR, 0.94; 95% CI, 0.89-0.98) among adults reporting serious distress, significant level (OR, 1.38; 95% CI, 1.15-1.66) and post-USPSTF trend (OR, 1.05; 95% CI, 1.01-1.10) increases in the probability of psychotherapy only, and level (OR, 0.88; 95% CI, 0.81-0.96) and post-USPTF trend (OR, 0.96; 95% CI, 0.94-0.98) decreases in the likelihood of antidepressants only among adults reporting mild or moderate distress, and no significant changes among adults reporting no distress. There was a significant level decrease (OR, 0.79; 95% CI, 0.70-0.89) in the probability of seeing a prescriber for psychotherapy after the recommendation. Conclusions and Relevance This study found that the USPSTF recommendation for routine adult depression screening was associated with increased likelihood of psychotherapy and decreased likelihood of antidepressant use among adults reporting some level of psychological distress. Findings suggest no association with unnecessary treatment among adults with low levels of distress.