All young and middle-aged adults should be screened for anxiety and depression at least once in their lifetime, according to a leading panel of physicians.
The US Preventive Services Taskforce (USPSTF) – one of the most influential agencies in US health care – said screening 19- to 64-year-olds has a “moderate net benefit.”
The group believes cases are going undiagnosed due to a shortage of doctors and a spike in mental health problems following the pandemic.
If doctors followed the task force’s recommendations, at least 195 million Americans would have to make a 10-minute appointment to complete a survey that screens them for the conditions.
It is the first time doctors have recommended routine screenings in a primary care setting and stems from a draft guideline published last October.
Experts cast a mixed tone on the move, with some announcing it as a “positive step forward” while others warned it could increase the risk of over-prescribing addictive drugs to treat mental health problems.
The US Preventive Services Taskforce – an influential health care panel – said there was a “moderate net benefit” for screening 19- to 64-year-olds. The panel also recommended depression screening for those over 65 (stock image)
Older adults over age 65 should only be screened for depression, the panel recommended.
However, there was insufficient evidence that the group should be screened for anxiety, which may be related to different mental health attitudes among older age groups.
In the 1960s, estimates suggested that 12 million adults had anxiety, while four million had depression.
But in subsequent decades, these numbers have skyrocketed. Estimates suggest that 40 million adults now have anxiety, while 19.3 million are thought to be depressed.
Modern lifestyles, including spending longer on cell phones and increased stress related to work, have been blamed for the upswing.
But it’s also thought that reduced stigma about mental health issues and increased awareness are to blame for the rise.
Anxiety was defined as a constant or disproportionate fear of everyday events, such as going to work, going home, or being in a public place. Depression was defined as having mild to severe persistent feelings of sadness for at least two weeks.
Make their recommendation today JAMAthe panel said everyone should be screened for anxiety and depression at least once.
The panel said that after the initial screening, doctors can use their “clinical judgment” for how often to check someone after that.
The screening could be done once a year or twice when young and middle-aged adults need to see their doctor for a routine checkup.
The advice is not binding, so doctors do not have to enforce it.
But the USPSTF guideline is normally picked up and implemented by medical agencies. It also increases the likelihood that insurance will cover further mental health screenings.
It has also previously been suggested that anyone who has symptoms that worry them or who has previously experienced a stressful life event — such as a divorce or moving to a new city — should get checked.
Studies can be conducted using surveys designed to screen the emotional well-being of participants.
For treatments, the panel recommended psychotherapy, such as talking to a psychologist, and benzodiazepines, such as Xanax, which work by acting on a chemical in the brain to induce feelings of calm.
But in a nod to emerging treatments like ketamine therapy for anxiety, the panel also said people can use “relaxation and desensitization therapies.”
The panel stopped recommending anxiety trials for older adults, however, over the age of 65, saying there was not enough evidence of benefit.
But on depression, the panel said there was a “moderate net benefit” for the group.
The above poll shows that more Americans are being diagnosed with depression than in previous years
And this chart, which tracks trends from 2020 to 2021, also shows an increase in the number of people diagnosed with anxiety
The panel recommended that all children ages 12 to 18 be screened for anxiety and depression by October last year.
publish their decision JAMA today the Task Force said, “Anxiety disorders are common mental illnesses. They often go unrecognized in primary care and there are significant delays in starting treatment.
The USPSTF concludes with moderate confidence that screening for anxiety disorders in adults, including pregnant and postpartum individuals (women), has a moderate net benefit.
“The USPSTF concludes that there is insufficient evidence for screening for anxiety disorders in older adults.”
Experts have eexpressed concern about these recommendations, fearing that it could lead to an overmedicated population and a new opioid-like crisis.
The most common anxiety drugs fall into the class of benzodiazepines, with highly addictive drugs such as Xanax, Klomopin, and Valium.
A person who takes the drugs every day to manage severe cases of anxiety could become dependent on them within weeks, studies suggest.
The body also builds tolerance to the drugs, meaning that a frequent user will need larger and larger doses over time for the drugs to work – further increasing the risk of addiction.
In the most extreme cases, users take to the streets where versions of the drug circulate that may contain dangerous contaminants such as fentanyl.
Fentanyl is the leading cause of the US overdose crisis, responsible for 70 percent of the 107,000 overdose deaths recorded in the US in 2021.
Dr. Gary Maslow, a psychiatrist at Duke University in North Carolina, commented on the approval NBC news: ‘This is a positive step forward.’
Dr. Wanda Nicholson, task force vice chair and public health expert in Washington DC, added, “This is a call to action.”