For first time, US task force recommends screening adults for anxiety disorders – WTOP News

Adults ages 19 to 64 in the United States should be screened for anxiety disorders, according to a new recommendation from the U.S. Preventive Services Task Force released Tuesday.


Adults aged 19 to 64 in the United States should be screened for anxiety disorders.

(CNN) — Adults ages 19 to 64 in the United States should be screened for anxiety disorders, according to a new recommendation from the U.S. Preventive Services Task Force released Tuesday.

The final recommendation, published in the medical journal JAMA, marks the first time the USPSTF has made a final recommendation on screening for anxiety disorders in adults, including those in pregnancy and postpartum. The task force found insufficient evidence to screen for anxiety in older adults.

The USPSTF, a panel of independent medical experts whose recommendations help guide physician decisions and influence insurance plans, also continues to recommend that all adults be screened for major depressive disorder, including those who are pregnant. or postpartum and the elderly.

The recommendation is consistent with the 2016 task forces recommendation on depression screenings.

While rates of clinical depression have been steadily increasing in the United States, they have increased significantly during the Covid-19 pandemic. Overall, about 1 in 6 adults will experience depression at some point in their life, according to the US Centers for Disease Control and Prevention.

And although depression and anxiety are different conditions, they commonly occur together, and such screening recommendations can help doctors identify which patients may need treatment for both conditions or one over the other.

Anxiety disorders are common and can really impact people’s quality of life, and what the task force found is that screening for anxiety disorders in the general adult population can lead to the early identification of these conditions and then, if the people identified are linked with appropriate care, they will benefit, said Dr. Michael Silverstein, vice president of the USPSTF and director of the Hassenfeld Child Health Innovation Institute at Brown University.

So it’s really great news for the provision of preventive services for the American public, he said. We also found that in the older adult population, which is defined as 65 and older, the Task Force really needs more evidence to weigh the risks and benefits of screening for anxiety disorders. And for that older adult population, we were calling for urgent new research.

We have not treated mental health on the same level as physical health

The USPSTF researchers noted in their Anxiety Screening Recommendation Statement that most people with anxiety disorders do not receive treatment within the first year of symptoms, if ever they show a need for more robust screening.

Only 11% of US adults with anxiety disorder started treatment within the first year of onset; the median time to treatment initiation was 23 years, the researchers wrote. A US study of 965 primary care patients found that only 41% of patients with anxiety disorder were receiving treatment for their disorder.

Once the new screening recommendations are put into real-world practice, the findings could reveal that anxiety disorders are far more prevalent than previously thought, said Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the recommendation statements.

Anxiety has been very hidden for a long time, so I think it’s good that they’re recommending screening the large population. When we start screening for anxiety, we’ll find far more of it than we thought it had, she said, adding that the nation should also prepare to make mental health services and treatments more easily accessible during the ongoing mental health crisis.

I think it’s an opportunity for us to get our hands on this crisis before we have a mental health emergency, Benjamin said. So we definitely need to do more. We know as a nation, we have little investment in mental health. We haven’t invested that much money in mental health. We have not treated mental health on the same level as physical health. And we know that people who need mental health services are really struggling to find providers to care for them.

What does screening look like

Medical professionals can screen for anxiety disorders using questionnaires and scales, such as asking about feeling on edge, not being able to stop or control worrying, or having difficulty relaxing, for example.

Some questions used to screen for depression include asking about feeling hopeless, having trouble concentrating, losing interest in daily activities, or thoughts about harming yourself. Major depressive disorder is defined as at least two weeks of persistent feelings of mild to severe sadness or lack of interest in daily activities, according to the USPSTF.

Any positive screening results should be confirmed with a diagnostic evaluation to determine the severity of symptoms and identify any other psychological problems, and then patients should receive treatment. Potential harms of screening include the risk of a false positive, leading to unnecessary appointments or unnecessary treatment, according to the USPSTF, but for most adults, screening and follow-up care can reduce symptoms of anxiety disorders and depression.

Effective treatments for anxiety disorders may include talking to a therapist, known as psychotherapy, or medications such as antidepressants or beta blockers, as well as relaxation or stress management therapies. Treatments for depression may also include antidepressant medications or psychotherapy, alone or in combination.

Left untreated, major depressive disorder can interfere with daily functioning and may be associated with an increased risk of cardiovascular events, exacerbation of comorbid conditions, or increased mortality, according to the USPSTF recommendation. Only about half of people with major depression are identified.

A call for more research on suicide risks

Research suggests that anxiety disorders and depression may be associated with suicidal thoughts, suicide attempts, and other types of suicidal behavior.

But the new USPSTF recommendations say there is insufficient evidence to recommend or against specific screening for suicide risk in adults who do not show signs or symptoms, which is consistent with the task forces’ 2014 recommendation on the issue.

So, if someone goes to the doctor or their primary care provider and expresses the idea of ​​harming themselves or wanting to harm themselves or wanting to die by suicide, by any means, that provider must do everything possible to help the patient to facing them, Silverstein said.

As a task force, we’re not looking at the evidence for that population, he said. We are looking at the evidence for people who come to their primary care physician without any signs or symptoms and asking the primary care provider or someone in the primary care providers office to ask them a series of screening questions to assess their risk of suicide.

In the new recommendations, the USPSTF is calling for more research on the risks of suicide among people who show no signs or symptoms.

Someone experiencing death by suicide is a tragedy, Silverstein said. As the suicide rate in this country is on the rise, there are so many people who have experienced the death of a loved one by suicide. So this recommendation is really important and that importance to me underscores that the American public deserves the highest quality evidence about screening for this really, really serious condition, which is suicide risk.

Mental health experts and advocates emphasize the importance of suicide risk assessments among adults diagnosed with anxiety and major depressive disorder.

While not stated in the USPSTF statement of recommendation, a positive anxiety screening result should be immediately followed by a clinical evaluation for suicide, Dr. Murray Stein and Dr. Linda Hill, both of the PhD, wrote in an editorial. ‘University of California, San Diego. which accompanied the new recommendations in JAMA.

Adoption of these new anxiety screening recommendations should provide momentum and an opportunity for primary care physicians to feel more comfortable with the diagnosis and treatment of anxiety disorders, which may require additional training , they wrote. Anxiety disorders can be distressing and disabling, and appropriate recognition and treatment can be life-altering and, in some cases, life-saving for patients.

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