The U.S. Preventive Services Task Force (USPSTF) for the first time is recommendingthat adults under the age of 65 receive screening for anxiety disorders. The final recommendation statement by the USPSTF was published today in JAMA.

“Amid the mental health crisis in the United States, the Task Force worked to provide primary care professionals and their patients with recommendations on evidence-based screening,” task force vice chair Michael Silverstein, M.D., M.P.H., said in a USPSTF Bulletin. “Fortunately, screening all adults for depression, including those who are pregnant and postpartum, and screening adults younger than 65 for anxiety disorders is effective in identifying these conditions so adults can receive the care they need.”

The USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine that makes recommendations about the effectiveness of preventive care services. The current recommendations were based on the findings of a systematic review to evaluate the benefits and harms of screening for anxiety disorders in asymptomatic adults aged 19 years and older, including those who were pregnant or postpartum.

In the JAMA report, the USPSTF described a review of 10 studies (n = 6,463) that evaluated the accuracy of screening for anxiety disorders using a variety of assessments in asymptomatic adults aged 19 years or older. The studies included older adults (those 65 years or older), pregnant patients, and participants seen in primary care settings who were evaluated for anxiety using such instruments as the Geriatric Anxiety Scale, the Edinburgh Postnatal Depression Scale anxiety subscale, and the Generalized Anxiety Disorder (GAD) scale.

The task force concluded that while there appears to be a moderate net benefit to screening adults for anxiety disorder, “the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety disorders in older adults [defined as those 65 years or older].”

What will happen when a patient screens positive for anxiety? asked Murray B. Stein, M.D., M.P.H., and Linda L. Hill, M.D., M.P.H., both of the University of California, San Diego, in an accompanying editorial. “Further evaluation is required at the point of screening to determine the level of acuity and need for referral or treatment,” they wrote, pointing to the importance of evaluating the patient for suicidality as well as posttraumatic stress disorder.

“The uptake of these new anxiety screening recommendations should provide an impetus and an opportunity for primary care clinicians to become more comfortable with diagnosing and treating anxiety disorders, which may require additional training,” Stein and Hill concluded. “Anxiety disorders can be distressing and disabling, and appropriate recognition and treatment can be life-altering and, in some cases, lifesaving, for patients.”

https://alert.psychnews.org/2023/06/us-preventive-services-task-force.html