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To the Editor: In his Clinical Crossroads discussion of a 52-year-old suicidal man,¹ Dr Jacobs rightly emphasizes the importance of suicide risk assessment by the primary care physician. Unfortunately, he endorses a broad program of screening for depression, noting that "Depression screening is simple, cost-effective, reliable, and potentially money saving. . . ." He notes that the suicidal ideation of the patient presented "would have been detected by a primary care physician using a depression screening tool." However, there are no data to support either statement, nor was there evidence that this suicidal patient had contact with a primary care physician during which an opportunity for suicide risk assessment was missed. Jacobs reaches the erroneous conclusion that the complex problems of detecting and treating depression or suicide can be addressed with simple screening maneuvers, a conclusion for which there is no empiric basis.²

Because the natural history of major depressive . . . [Full Text of this Article]

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