Screening for Anxiety Advocated by Preventive Services Task Force
The US Preventive Services Task Force in September issued a draft recommendation for universal screening for mental health conditions to include anxiety as well as depression, but it stopped short of recommending suicide risk screening for all adults.
The Task Force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, is seeking comments on its latest recommendations by Oct. 17. The recommendations apply to all adults seeking medical care who do not otherwise show symptoms of a behavioral disorder.
"What we found was that screening for anxiety in adults younger than 65, including people who are pregnant and postpartum, can help identify anxiety early so people can be connected to the care they need," said Lori Pbert, Ph.D., a clinical psychologist and University of Massachusetts Chan Medical School professor, who serves on the task force, interviewed by ABC News. "This recommendation is specifically for individuals who do not have a mental health diagnosis and are not showing recognized signs or symptoms of an anxiety disorder." The anxiety screening recommendation is of particular importance to women, who suffer from anxiety disorder at greater rates than men, according to the National Institute of Mental Health.
The Task Force also recommends screening for depression for adolescents 12 and older who do not otherwise show symptoms.
According to the National Institute for Mental Health, studies have shown that about half of the U.S. population may experience an episode of depression in their lifetime. Depression is one of the most common mental health concerns in the United States.
Another study recently published in the Journal of the American Medical Association, indicates that depression screening – and resulting followup treatment – may improve health outcomes for physical ailments. “Because depression impacts so many other chronic diseases, implementation of routine depression screening could also improve patient outcomes for complications from other conditions,” said Maria E. Garcia, an assistant professor of medicine and epidemiology at the University of California - San Francisco.
The Preventive Services Task Force said there is a lack of evidence for recommending suicide screening for asymptomatic individuals, either adolescents or adults.
“More research is also critically needed on the role of screening for suicide risk. Although suicide is tragically a leading cause of death among adults, there is not enough evidence on whether screening those without recognized signs or symptoms helps prevent suicide,” says Task Force member Gbenga Ogedegbe, M.D., M.P.H. “In the absence of evidence, healthcare professionals should use their judgment based on individual patient circumstances when determining whether or not to screen.”
A more proactive approach is favored by the American Academy of Pediatrics (AAP) which recommends universal suicide risk screening for all adolescents over 12 years old, regardless of presenting symptoms. The recommendations are part of its “Blueprint for Youth Suicide Prevention.” issued in 2021.
The AAP cites several reasons why suicide screening is so important for adolescents:
Most young people keep suicidal thoughts to themselves and may not bring up the topic on their own if they aren’t asked a direct question
While patients who present with a behavioral health concern are at a significantly higher risk for suicide, patients presenting with other health concerns or even those simply engaging with the medical system for preventive care can have pressing mental health concerns that they are not talking about with anyone
Universal screening is an important way to help all patients feel less alone with suicidal thoughts. Otherwise, they may pass through healthcare settings undetected.
The AAP also cites research that most people, of any age, who die by suicide have visited a healthcare provider in the weeks or months before to their death, and that less than half had a recent mental health diagnosis. The AAP concludes: “Asking about suicide risk can be a way to recognize someone at risk and get them help.”