For the first time, the draft US task force recommends screening for anxiety in adults


The US Preventive Services Task Force says for the first time that adults younger than 65 should be screened for anxiety, according to a draft recommendation released Tuesday.

The USPSTF is a group of independent medical and disease prevention experts whose recommendations help guide doctors’ decisions. The draft recommendation is not final, but will now enter a public comment period.

The panel found “that screening for anxiety in adults younger than 65, and that includes those who are pregnant and postpartum … can help identify anxiety early,” Lori Pbert told CNN, member of the working group. “So it’s really exciting.”

The task force defines anxiety disorders as “characterized by an increased duration or intensity of the stress response to everyday events.” Recognized types include generalized anxiety disorder, social anxiety disorder, and agoraphobia. The USPSTF drafts also recommend screening for major depressive disorder in adults, consistent with recommendations for depression screening published in 2016.

Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, said an anxiety recommendation was prioritized “because of its importance to public health, especially with increased attention to mental health in this country that we’ve had in the past few years.”

The Covid-19 pandemic led to a rise in new anxieties and depression, although levels have fallen somewhat since then. A recent CDC report found that adults ages 18 to 44 were the least likely to have received mental health treatment in 2019, but became the most likely in 2021.

The anxiety recommendation would apply to adults aged 19 and older who do not have a diagnosed mental health disorder. Depression screening recommendations apply to those over the age of 18 who do not have a diagnosed mental health disorder and who do not show any recognized signs of depression or suicide risk.

Pbert emphasized that people who already have signs or symptoms should be evaluated and connected to care.

Brief screening tools for both anxiety and depression have been developed and are available for use in primary care. Most current screening tools include questionnaires and scales.

Any positive screening results should lead to further confirmatory evaluations, the task force says. It also notes that there is little evidence about the optimal timing and interval for screening, and more evidence is needed.

The USPSTF says that in the absence of data, a pragmatic approach could include screening all previously unscreened adults and using clinical judgment to consider other factors, such as underlying health conditions and life events, to make decisions about whether to screen further. necessary for people who are at high risk.

The recommendations for screening for anxiety and depression are what the USPSTF calls “B” ratings, meaning a physician should offer the service because there is a “moderate net benefit.”

Also included in the draft recommendations are two “I” statements, which do not have enough evidence to recommend for or against the screening, Pbert said. The statements are for the detection of anxiety in adults over 65 and for the detection of suicide risk in adults. The task force calls for more research on the two topics of the I statement to help older Americans, as well as to understand the role of primary care in suicide prevention.

“There are missed opportunities within primary care practice, which is why we need research to understand how best to detect people who don’t have recognized signs or symptoms of suicide risk, identify them and connect them carefully,” he said.

Screening for anxiety disorders is important because of the lifetime prevalence in the US, which the draft recommendations put at 26 percent for men and 40 percent for women, Pbert noted.

“This is a very common mental health issue,” he said. “That’s why it’s so important for us to address anxiety disorders and screen for anxiety disorders.”

The draft recommendations for screening for anxiety, depression, and suicide risk came together because “we really want to help primary care physicians address the urgent need to address the mental health of adults in the United States,” he said. said Pbert. “So we’re really seeing this set of recommendations as an opportunity to be able to provide clinicians working with adult patients with comprehensive guidance on how to approach screening for anxiety, depression and suicide risk.”

Task force members also hope the recommendations will raise awareness of the need for mental health screening and treatment.

“This is an area where we need a lot of work,” Pbert said. “There are so many gaps in the provision of mental health care, and our hope is that this set of recommendations will address that.”

The task force is also very concerned about health equity, Pbert said.

“Our hope is that by raising awareness of these issues and having recommendations for clinicians, we can help all adults in the United States, including those who experience disparities,” he said.

The public will be able to comment on the draft recommendations until October 17.

“We would like people to be honest, to provide their input and perspective,” Pbert said, adding that the task force will read all comments. “It is very important because it allows us to listen to the public, and the public includes people who specialize in these areas. … We greatly value the input of other specialists who can give us their perspective and their comments.”

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