All young and middle-aged adults should be screened regularly for anxiety and depression, even if they have no symptoms, an influential public health group said on Tuesday.
Although the U.S. Preventive Services Task Force has recommended physicians evaluate patients for depression since 2002, it’s the first time the group has advocated for routine anxiety screening in adults. Pregnant women and those who have given birth within the last year were highlighted as people who should be screened.
“This is a call to action,” Dr. Wanda Nicholson, vice chair of the task force and professor of prevention and community health at the George Washington Milken Institute of Public Health in Washington, DC, said in an interview.
The guidance comes as emotional stress has skyrocketed in recent years, driving increasing calls for the limited number of counselors and therapists nationwide.
“We recognize that there can be limitations in terms of access to mental health providers within the health care system,” Nicholson said.
There was not enough evidence to support screening for adults 65 and older, the task force said.
The Preventive Services Task Force is made up of independent health experts who volunteer their time to analyze all the scientific data on a particular topic and who then make recommendations based on that dataset.
The guidance may affect reimbursements from insurance companies, but doctors are not required to follow the group’s recommendations, which were published Tuesday in the Journal of the American Medical Association. The recommendations are considered final, and a mirror draft was published last fall on the matter.
“This is a welcome step forward,” said Dr. Gary Maslow, an associate professor of psychiatry and behavioral sciences at Duke University who was not involved with the new guidance.
The task force previously recommended that 8-year-olds be screened for anxiety disorder.
What is the test for anxiety?
Screening for anxiety is usually done through questionnaires during a doctor’s visit. Doctors want to know how many times in the past two weeks a patient has been easily annoyed or irritable, bothered by uncontrollable worry, or felt so restless that it was difficult to sit still.
Depending on the results, a doctor might prescribe medication or refer the patient to a specialist who treats anxiety disorders.
Chivonna Childs, a staff psychologist at the Cleveland Clinic, said screening is important because symptoms of anxiety or depression may not be apparent during regular doctor visits.
“Not everyone will come to your office in a ball of nerves, shaking, having panic attacks,” Childs said. “Most people have none of that.”
Screening tools are not diagnostic, Maslow stressed.
“When you test someone you say, ‘OK, you have some of the symptoms that are consistent with anxiety. Let’s talk about that in more detail and see if you meet the criteria for this condition,'” she said.
The task force recommendations specifically referred to pregnant and postpartum women. “In many ways, they’re a diverse population,” Nicholson said.
Previous surveys have found that mental health problems and stress among pregnant women have tripled in recent years.
Furthermore, there was not enough evidence to suggest that screening would be effective for assessing suicide risk in adults.
“We urgently call for more research to determine the effectiveness of screening all adults for suicide risk,” Dr. Gbenga Ogedebbe, task force member and professor of population health and medicine at New York University.
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network, formerly known as the National Suicide Prevention Lifeline, at 800-273-8255text HOME to 741741 or visit SpeakingOfSuicide.com/resources for more resources.
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