US doctors should regularly screen all adults under 65 for anxiety, a major health guidelines group suggested Tuesday.
This is the first time that the US Preventive Services Task Force recommends stress screening in primary care for asymptomatic adults. The proposal is open for public comment until Oct. 17, but the group typically confirms its guidance plan.
The recommendations are based on a review that began before the COVID-19 pandemic, evaluating studies showing potential benefits and risks of screening. Given reports of an increase in mental health problems linked to pandemic isolation and stress, the guidance is “very timely,” said task force member and co-author Lori Pbert. Pbert is a psychologist-researcher at the Chan University of Massachusetts Medical School.
The task force said the evidence for benefits, including effective treatments, outweighed the risks, which included inaccurate test results that could lead to unnecessary follow-up.
Anxiety disorders are among the most common mental health complaints, affecting about 40 percent of U.S. women at some point in their lives and more than 1 in 4 men, Pbert noted.
Black people, those living in poverty, people who have lost partners and those with other mental health problems are among adults who face higher risks of developing anxiety, which can manifest as panic attacks, phobias or feeling constantly overwhelmed. 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 normal activities. These can easily be given in a primary care setting, the task force said, although it did not specify how often patients should be tested.
“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 thorough evaluation by a mental health professional, though Pbert acknowledged that finding mental health care can be difficult. specialist shortages.
Megan Whalen, a 31-year-old marketing professional who was diagnosed with anxiety in 2013, says regular doctors should screen for mental health issues 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 has been helped by medication and speech therapy, but her symptoms worsened during the pandemic and she temporarily moved back home.
“The pandemic made me afraid to leave the house, my anxiety telling me anywhere outside my childhood home was not safe,” Whelan said. “I still struggle with feelings of dread and fear sometimes. It’s just a part of my life at this point, and I try to manage it as best I can.”
The task force said there is not enough solid research in older adults to recommend for or against anxiety screening in people age 65 and older.
The group continues to recommend depression screening for adults and children, but said there is not enough evidence to assess the potential benefits and harms of suicide screening in adults who are not experiencing worrisome symptoms.
In April, the group issued similar draft guidance for children and adolescents, recommending screening for anxiety but saying more research is needed on the potential benefits and harms of screening children for suicidality without obvious signs.
Guidelines from the task force often dictate insurance coverage, but anxiety 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 care stress screening for women and girls starting at age 13.
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, control your stress.’ Yes, I get it,’ but not everyone knows how, said the 42-year-old mother of three. “It’s hard to prioritize self-care, but it’s necessary.”
Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.
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