(CNN) — The US Preventive Services Task Force (USPSTF) states for the first time that adults under the age of 65 should be screened for anxiety, according to a draft recommendation released Tuesday. .
The USPSTF is a group of independent experts in disease prevention and medicine whose recommendations help guide physician 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 pregnant and postpartum women … can help identify anxiety early,” said Lori Pbert, a member of the task force. , to CNN. “So it’s really exciting.”
The task force defines anxiety disorders as “characterized by increased duration or intensity of a stress response over 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 the recommendations for screening for depression published in 2016.
Pbert, a clinical psychologist and professor at the University of Massachusetts Chan School of Medicine, said a recommendation on anxiety was prioritized “because of its public health importance, especially with increased attention to mental health in this country that we have had in recent years.
The covid-19 pandemic caused an increase in new cases of anxiety and depression, although levels have dropped 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.
Assessment tools available
The anxiety-related recommendation would apply to adults age 19 and older who do not have a diagnosed mental health disorder. The depression screening recommendations apply to those over the age of 18 who do not have a diagnosed mental health disorder and do not show any recognized signs of depression or suicide risk.
Pbert stressed that people who are already showing signs or symptoms should be evaluated and referred for care.
Brief screening tools for both anxiety and depression have been developed and are available for use in primary care settings. Most current assessment tools include questionnaires and scales.
The working group states that any positive assessment results should lead to further confirmatory assessments. It also notes that there is little evidence on the optimal timing and interval for screening, and that more evidence is needed.
The USPSTF states that, in the absence of data, a pragmatic approach might include evaluating all adults who have not previously undergone screening and using clinical judgment to consider other factors, such as underlying health conditions and life events. life, to make decisions about whether further evaluation is 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 clinician should offer the service because there is “moderate net benefit.”
Also included in the draft recommendations are two statements, which do not have enough evidence to recommend for or against the assessment, Pbert said. The statements are for the assessment of anxiety in adults over 65 years of age and for the assessment of suicide risk in adults. The task force calls for more research on the two topics of the claims to help older Americans and understand the role of primary care in suicide prevention.
“There are missed opportunities within primary care practice, and so we need to do research to understand how best we can screen people who don’t have recognized signs or symptoms of suicide risk, so we can identify and connect them.” with attention,” he said.
Mental health care awareness
Screening for anxiety disorders is important because of their lifetime prevalence in the US, which the draft recommendations put at 26% for men and 40% for women, Pbert said.
“This is a very common mental health problem,” he said. “That’s why it’s so important that we address anxiety disorders and their detection.”
The draft recommendations for screening for anxiety, depression, and suicide risk have been put together because “we really want to help primary care physicians address the urgent need to address mental health in adults in America” Pbert said. “So we really see 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 assessment and treatment.
“It’s an area that we need to do a lot of work on,” Pbert said. “There are many gaps in the delivery of mental health care, and our hope is that this set of recommendations will fill those gaps.”
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 America, including those experiencing disparities,” he said.
The public will be able to comment on the draft recommendations until October 17.
“We’d like people to be honest, to bring their opinions and perspectives,” Pbert said, adding that the task force will read all comments. “It’s really important because it allows us to listen to the public, and the public includes people who are specialists in these areas… We really value the input of other specialists who can give us their perspective and feedback.”