American doctors should regularly screen all adults under 65 for anxiety, an influential health guidelines group suggested Tuesday.
This is the first time the US Preventive Services Task Force has recommended screening for anxiety in primary care for asymptomatic adults. The proposal is open for public comment until October 17, but the group usually confirms its draft guidance.
The recommendations are based on a review that began before the COVID-19 pandemic, evaluating studies showing the potential benefits and risks of screening. Given reports of a rise in mental health issues related to pandemic isolation and stress, the guidelines are “very timely,” said Lori Pbert, a task force member and co-author. Pbert is a research psychologist at the University of Massachusetts Chan School of Medicine.
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The task force said evidence of benefits, including effective treatment, outweighed any risks, which included inaccurate screening results that could lead to unnecessary follow-up care.
Anxiety disorders are among the most common mental complaints, affecting about 40 percent of U.S. women at some point in their lives and more than 1 in 4 men, Pbert noted.
Blacks, people living in poverty, people who have lost partners, and those with other mental health problems are among adults who face a higher risk of developing anxiety, which can manifest as panic attacks. phobias or a feeling of constant tension. In addition, 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. They could easily be given in a primary care setting, the task force said, although it did not specify how often patients should be screened.
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“The most important thing to recognize is that a screening test alone is not enough to diagnose anxiety,” Pbert said. The next step is a more in-depth evaluation by a mental health professional, although Pbert acknowledges that finding mental health care can be difficult given the shortage of specialists.
Megan Whalen, a 31-year-old marketing professional who was diagnosed with anxiety in 2013, says regular doctors should screen for mental health problems as often as they do for physical problems.
“Health is health, whether the problem is visible or not,” said Whalen, of Hoboken, New Jersey.
She received help from medicine and speech therapy, but her symptoms worsened during the pandemic and she temporarily returned home.
“The pandemic has made me afraid to leave home, my anxiety telling me that anywhere outside my childhood house is dangerous,” Whelan said. “I still struggle with feelings of fear and dread at times. It’s just part of my life at this point and I’m trying to manage it as best I can.
The task force said there is not enough robust research in older adults to recommend for or against screening for anxiety in those age 65 and older.
The group continues to recommend screening for depression in adults and children, but said there is insufficient evidence to assess the potential benefits and harms of suicide screening in adults who do not show anxiety symptoms.
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In April, the group issued similar draft guidance for children and teens, recommending screening for anxiety but saying more research is needed on the potential benefits and harms of screening for suicide in children without obvious signs.
Task force guidelines often dictate insurance coverage, but the concern is already on the radar of many primary care physicians. In 2020, a panel affiliated with the American College of Obstetricians and Gynecologists recommended routine primary screening for anxiety in women and girls starting at age 13.
Melissa Luis-Duarte, a wellness coach in Scottsdale, Arizona, says rhythmic breathing, meditation, and making a daily list of three things she’s grateful for have 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 it’s necessary.”
For those suffering from depression and suicidal thoughts, or if someone you know is struggling, call the National Suicide Prevention Lifeline at 1-800-273-8255 or find them online at https://suicidepreventionlifeline .org.