By LINDSEY TANNER, AP Medical Writer
US doctors should regularly screen all adults under the age of 65 for anxiety, an influential group of health guidelines proposed Tuesday.
It is the first time the US Preventive Services Task Force has recommended screening for anxiety in primary care for adults without symptoms. The proposal is open for public comment until Oct. 17, but the group generally affirms its draft guidance.
The recommendations are based on a review that began before the COVID-19 pandemic, evaluating studies that show the potential benefits and risks of screening. Given reports of an increase in mental health problems related to stress and pandemic isolation, the guidance is “very timely,” said Lori Pbert, a task force member and co-author. Pbert is a psychologist and researcher at Chan at the University of Massachusetts. Medicine School.
The task force said the evidence of benefits, including effective treatments, outweighs any 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 percent of US 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 their partners and those with other mental health problems are among the adults who face a higher risk of developing anxiety, which can manifest as panic attacks, phobias or always feeling nervous. Additionally, 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 administered 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 given a shortage of specialists.
Megan Whalen, a 31-year-old marketer who was diagnosed with anxiety in 2013, says regular doctors should check for mental health issues just as often as physical ones.
“Health is health, whether the problem is visible or not,” said Whalen, of Hoboken, New Jersey.
He was helped by medication and talk therapy, but his symptoms worsened during the pandemic and he temporarily moved home.
“The pandemic made me afraid to leave the house, my anxiety told me that anywhere outside of my childhood home was not safe,” Whelan said. “Sometimes I still struggle with feelings of dread and fear. It’s just a part of my life right now, and I try to handle it the best I can.”
The task force said there isn’t enough strong research in older adults to recommend for or against screening for anxiety in people 65 and older.
The group continues to recommend depression screening for adults and children, but said there isn’t enough evidence to assess the potential benefits and harms of screening for suicide in adults who don’t show worrying symptoms.
In April, the group issued a draft of similar guidance for children and adolescents, 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 determine insurance coverage, but anxiety 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 ages 13 and older.
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 helped with her anxiety.
“Doctors say, ‘Make sure you sleep, manage your stress.’ Yeah, I get it,” but not everyone knows how, the 42-year-old mother of three said. “It’s hard to prioritize self-care, but that’s what’s necessary.”
Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.
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