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The task force defines anxiety disorders as “characterized by greater duration or intensity of the stress response to everyday events.” Recognized types include generalized anxiety disorder, social anxiety disorder, and phobias. The USPSTF draft also recommends screening for major depressive disorder in adults, in line with recommendations for depression screening published in 2016.
Pubert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, said the concern recommendation was prioritized “because of its public health importance, especially in this country with the increasing focus on mental health that we have seen in the past.” Been doing it since. A few years.”
Screening tools already available
The Anxiety recommendation would apply to adults age 19 and older who have not been diagnosed with a mental health disorder. Depression screening recommendations apply to people 18 years of age and older who are not diagnosed with a mental health disorder and are not showing any recognized symptoms of depression or an increased risk of suicide.
Pubert emphasized that people who are already showing signs or symptoms should be evaluated and linked to care.
Brief screening devices have been developed for both anxiety and depression and are available for use in primary care. Most current screening tools include questionnaires and scales.
The task force says that any positive screening result should lead to additional confirmatory assessments. It also notes that there is little evidence about the optimal timing and interval for screening, and more evidence is needed.
The USPSTF says that in the absence of data, a practical approach may include screening all adults who have not previously been screened and clinical considerations to consider other factors, such as underlying health conditions and life events. Involves using judgment to decide whether to have additional screening. Essential for people at high risk.
Recommendations for anxiety and depression screening are what the USPSTF calls a “B” classification, which means that the service a physician must offer because there is a “moderate net benefit.”
Pubert said the draft recommendations also included two “eye statements” that do not have sufficient evidence to make a recommendation for or against screening. The statements are intended for anxiety screening in adults over the age of 65 and for the risk of suicide in adults. Statement I calls for more research on both topics to be able to help older Americans as well as better understand the role of primary care in suicide prevention.
“There are missed opportunities within primary care practice, and this is why we need research to understand how best we can screen individuals who do not have signs or symptoms of suicide risk, So that we can identify them and add their care,” she said.
Raising awareness of mental health care
Screening for anxiety disorders is important because of the lifetime prevalence in the U.S., which put the draft recommendations at 26% for men and 40% for women, Pbert noted.
“It’s a very common mental health concern,” she said. “This is why it is so important for us to address anxiety disorders and investigate anxiety disorders.”
The draft recommendations for anxiety, depression and suicide risk screening came together because “we really want to help primary care physicians address the urgent need to address mental health in adults in the United States,” Pubert said. “So we’re really looking at this set of recommendations as an opportunity to be able to provide to clinicians who are working with adult patients, in terms of approaches to screening for anxiety, depression, and risk of suicide.” in comprehensive guidance.”
Members of the task force also hope that the recommendations will raise awareness of the need for mental health screening and treatment.
“This is an area in which we need to work a lot,” Pubert said. “There are a lot of gaps in terms of providing mental health care, and our hope is that this set of recommendations will elevate that.”
The task force is also very concerned about health equity, Pubert said.
“Our hope is that by raising awareness of these issues and making recommendations for physicians, we will be able to help all adults in the United States, including those experiencing disparities,” she said.
The public will be able to comment on the draft recommendations till October 17.
“We want people to be honest, provide their input and point of view,” Pubert said, adding that the task force will read every comment. “It’s really important because it’s allowing us to hear from the public – and the public includes people who are experts in these areas. … We really value the input of other experts who can give us their point of view. and give their comments.”