U.S. doctors should regularly screen all adults under 65 for anxiety, an influential group of health guidelines suggested Tuesday.
It’s the first time the U.S. Preventive Services Task Force has recommended anxiety screening in primary care for adults with no symptoms. The proposal is open for public comment until October 17, but the group usually confirms its draft guidelines.
The recommendations are based on a review that began before the Covid-19 pandemic, evaluating studies demonstrating potential benefits and risks of screening. Given the reports of an increase in mental health problems related to pandemic isolation and stress, the guidance comes “very timely,” said Lori Pbert, a member of the task force and co-author. Pbert is a psychologist researcher at the University of Massachusetts Chan Medical School.
The task force said the evidence for benefits, including effective treatments, outweighs the risks, including inaccurate screening results that could lead to unnecessary follow-up care.
Anxiety disorders are among the most common mental health complaints, affecting about 40% of American women at some point in their lives and more than 1 in 4 men, Pbert noted.
Black people, people living in poverty, people who have lost a partner and people with other mental health problems are among the adults who are at greater risk of developing anxiety, which can manifest as panic attacks, phobias or the feeling of being always on edge. stand. Also, about 1 in 10 pregnant and postpartum women experience anxiety.
Common screening tools include short questionnaires about symptoms such as fears and worries that interfere with usual activities. These can be easily given in a primary care setting, the task force said, although it didn’t specify how often patients should be screened.
“The important thing to recognize is that a screening test alone is not enough to diagnose anxiety,” Pbert said. The next step is a more thorough evaluation by a mental health professional, although Pbert acknowledged that finding mental health professionals can be difficult given the lack of specialists.
Megan Whalen, a 31-year-old marketing specialist who was diagnosed with anxiety in 2013, says mainstream doctors should screen for mental health issues as often as they do physical issues.
“Health is health, whether the problem is visible or not,” says Whalen of Hoboken, New Jersey.
She has received help from medications and talk therapy, but her symptoms worsened during the pandemic and she temporarily moved home.
“The pandemic scared me out of the house, my fear of telling me that anywhere outside my childhood was unsafe,” Whelan said. “I still struggle with feelings of fear and anxiety at times. It’s just part of my life right now and I’m trying to manage it as best I can.”
The task force said there isn’t enough solid research in older adults to recommend screening for anxiety in people over 65.
The group continues to recommend depression screening for adults and children, but said there is insufficient evidence to evaluate the potential benefits and harms of suicide screening in adults who do not show worrisome symptoms.
In April, the group released similar draft guidelines for children and teens, recommending anxiety screening, but stating that more research is needed on the potential benefits and harms of children undergoing suicide screening with no obvious signs.
Task force guidelines often dictate insurance coverage, but fear is already on the radar of many primary care physicians. In 2020, a group affiliated with the American College of Obstetricians and Gynecologists recommended routine primary care anxiety screening for women and girls as young as 13 years old.
Melissa Lewis-Duarte, a wellness coach in Scottsdale, Arizona, says rhythmic breathing, meditation, and making a daily list of three things she’s grateful for have all helped with her anxiety.
“Doctors say, ‘Make sure you sleep, manage your stress.’ Yes, I get that,” but not everyone knows how, said the 42-year-old mother of three. “It’s hard to prioritize self-care, but that’s what it takes.”
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