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Anxiety Screening Tests Recommended by US Task Force Will Cause Overdiagnosis, Overprescription, Psychologist Warns


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Pushing primary care doctors to screen all patients for anxiety will lead to over-diagnosis and over-prescribing, as well as exacerbate existing shortages in mental health resources, a psychologist said.

“It’s the wrong solution at the wrong time,” said Dr. Jonathan Shedler, a clinical professor. of psychiatry at the University of California, San Francisco, to Fox News. “You can’t just divide the world into disorders and think you’re doing an adequate job of determining someone’s mental health needs.”

Earlier this month, the United States Preventive Services Task Force recommended that all adults under the age of 65 get an anxiety test as more Americans report symptoms of mental health problems following the COVID pandemic. -19. The advisory group, which released the guidance as a draft, said the purpose was to help prevent mental health disorders from going undetected and untreated.

“It’s just terrible to give someone a seven-question quiz in the office and write a prescription on that basis without addressing the big picture,” said Shedler, the author of more than 100 academic and scientific papers in psychology.

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The US Preventive Services Task Force has recommended that primary care physicians screen all patients under the age of 65 for anxiety disorders.
(iStock)

More than 30% of adults reported symptoms of an anxiety disorder or depression this summer, the Estimates from the National Center for Health Statistics. The share of adults receiving mental health treatment increased to nearly 23% in 2021, up from 19% in 2019, according to the Centers for Disease Control and Prevention.

Shedler worries that mass screening will lead to misdiagnosis, causing doctors to prescribe anxiety medications to patients who may not need them.

“Primary care is not the place to get mental health care,” Shedler said. “Doctors don’t have the time. They don’t have the resources. They don’t have the training.”

The psychologist pointed to a similar recommendation made by the panel in 2002 to standardize depression screening tests, which was followed by an increase in people diagnosed with and prescription antidepressants. In 1996, approximately five million people were taking antidepressants. That number rose steadily to 13 million in 2015, according to a study by Frontiers in Psychiatry.

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A member of the federal task force, the CEO of the American Psychological Association, Arthur C. Evans, he told The Wall Street Journal that the group’s recommendation “is a really important step forward” in the country’s ongoing battle against mental health. “Screening for mental health conditions is critical to our ability to help people at the earliest possible time,” she said.

Shedler, who has done extensive research on these types of standardized screening tests, said they are ineffective at identifying mental health disorders.

Dr. Jonathan Shedler said that standardized anxiety tests could lead to misdiagnosing patients with a mental health disorder.

Dr. Jonathan Shedler said that standardized anxiety tests could lead to misdiagnosing patients with a mental health disorder.
(FoxNews)

“Psychiatric difficulties do not exist in a vacuum,” the psychologist told Fox News. “I think for a large number of people, the world feels increasingly insecure and unpredictable.”

“There is a difference between anxiety and fear,” he added. “In the evaluation questionnaires, there is no distinction.”

Shedler said he’s concerned that simplified screening tests will produce false positives.

“This type of screening is going to diagnose a large number of people with a disorder and a good number of them will end up on a lifelong journey of one drug and one treatment after another,” the doctor said. “When in fact they are responding to realistic circumstances in the world.”

“There’s a lot going on in society, in culture, financially, politically, that leaves people feeling extremely vulnerable,” Shedler told Fox News. She said that fear often stems from these external dangers, while anxiety “is a response to dangers that arise internally, psychological dangers.”

“If it’s not anxiety, but fear of something out there, psychological treatment is not going to be the answer,” he said.

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The task force classifies anxiety by several elements, including generalized anxiety disorder, social anxiety disorder, panic disorder, separation anxiety disorder, phobias, and selective mutism.

The task force classifies anxiety by several elements, including generalized anxiety disorder, social anxiety disorder, panic disorder, separation anxiety disorder, phobias, and selective mutism.
(iStock)

Additionally, as mental health problems rise, clinicians have raised concerns about the scarcity of resources for those seeking help.

“We have a chronic shortage of psychiatrists, and it will only grow,” said Saul Levin, MD, CEO and medical director of the American Psychiatric Association during a May briefing. “People can’t get care. It affects their lives, their ability to work, socialize or even get out of bed.”

By 2024, the US will fall short between 14,280 and 31,109 psychiatristsand psychologists, social workers and others will also be overburdened, according to to a study published in Psychiatry Online.

Shedler said the lack of adequate mental health care will only get worse if the federal task force’s recommendation is finalized, as the number of patients seeking treatment will increase without proportionally adding mental health professionals.

He also noted that health insurers often do not cover mental health treatment. When they do, often only low-quality care is covered, creating another barrier for those seeking treatment, according to Shedler.

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“A competent and trained mental health professional has the expertise to break down what is a psychological difficulty that we can treat in psychotherapy, where medication is a reasonable part of comprehensive treatment and when it is not,” he told Fox News.

“That’s what we’re doing. It’s not what a primary care doctor can do with a seven-question questionnaire,” Shedler said.

The draft of the proposed guide is open for public comment until October 17.



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