All young and middle-age adults should be screened regularly for anxiety and depression, even if they don't have symptoms, an influential public health group said Tuesday.
While the U.S. Preventive Services Task Force has recommended doctors assess patients for depression since 2002, it is the first time the group has advocated for routine screening of anxiety in adults. Pregnant women and those who gave birth within the past year were highlighted as people who should be screened.
"This is a call to action," Dr. Wanda Nicholson, vice chair of the task force and a professor of prevention and community health at the George Washington Milken Institute of Public Health in Washington, D.C., said in an interview.
The guidance comes as emotional stress has skyrocketed in recent years, increasing demands on the limited number of counselors and therapists nationwide.
"We recognize that there can be limitations in terms of access to mental health providers within the health care system," Nicholson said.
There was not enough evidence to back screening for adults 65 and older, the task force said.
The Preventive Services Task Force is made up of independent health experts who volunteer their time to analyze all of the scientific data on a particular subject, and who then make recommendations based on that set of data.
The guidance may influence insurance company reimbursements, but doctors are not required to follow the group's recommendations, which were published Tuesday in the Journal of the American Medical Association. The recommendations are considered final, and mirror draft guidance on the topic was released last fall.
"This is a positive step forward," said Dr. Gary Maslow, an associate professor of psychiatry and behavioral science at Duke University who was not involved with the new guidance.
The task force previously recommended that children as young as 8 be screened for anxiety disorder.
What is the test for anxiety?
Screening for anxiety is usually done through questionnaires during a doctor's office visit. Doctors want to know how often within the past two weeks a patient has been easily annoyed or irritable, bothered by uncontrollable worries or feeling so restless that it's difficult to sit still.
Depending on the results, a doctor could prescribe medication or refer the patient to a specialist who treats anxiety disorders.
Chivonna Childs, a staff psychologist at the Cleveland Clinic, said screening is important because anxiety or depression symptoms may not be obvious during regular doctor visits.
"Not everybody's going to come in your office in a ball of nerves, shaking, having panic attacks," Childs said. "Most people don't have any of that."
The screening tools are not diagnostic, Maslow stressed.
"When you screen someone you say, 'OK, you have some of the symptoms that are consistent with anxiety. Let's talk about that more in detail and see if you meet the criteria for this condition,'" he said.
The task force's recommendations specifically referred to pregnant and postpartum women. "In many ways, they are a different population," Nicholson said.
Previous surveys have found that mental health issues and stress among pregnant women have tripled in recent years.
There was also not enough evidence to suggest screening would be effective for assessing the risk of suicide in adults.
"We are urgently calling for more research to determine the effectiveness of screening all adults for suicide risk," Dr. Gbenga Ogedegbe, a task force member and professor of population health and medicine at New York University, said in a statement.
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network, previously known as the National Suicide Prevention Lifeline, at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
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