SCENARIO
A recently married 27-year-old male was seen for a new patient physical exam by a family medicine physician. He told the physician that he had not seen a doctor since his pediatrician and that he wanted a checkup before trying to start a family. The physician determined, in addition to a general health screen, to perform an anxiety screen.
Clinical Information Around Anxiety Screening
Anxiety is a common condition in the general population that can lead to health care avoidance, care plan noncompliance, functional impairment, adverse cardiac events, and possibly higher rates of suicide. Although anxiety may respond favorably to medications and psychotherapy, it remains an underdiagnosed condition. This is chiefly from the fact that many patients have simply never been screened by their health care providers, and the implementation of screening can help keep a patient from these potentially preventable outcomes.
The U.S. Preventive Services Task Force (USPSTF) has updated its guidance around screening for anxiety in children/adolescents and adults. Although USPSTF does not set standards of care, its information contributes to the overall factors to consider when caring for patients.
- The USPSTF has divided the population to be screened into two categories. The first, children and adolescents, includes individuals aged 18 years and younger. The second, adults, includes individuals aged 19 years and older.
- For children and adolescents, the USPSTF notes that anxiety disorder is common in this population, affecting approximately 8% of individuals, and often presents with excessive fear or worry as well as other emotional and physical symptoms. However, due to the high prevalence of the condition and its potential morbidity, the recommendation is to screen all children and adolescents irrespective of whether they are showing recognized signs or symptoms of anxiety.1
- For adults, the USPSTF also notes the high prevalence of anxiety disorders and reports that the conditions are often unrecognized, leading to the potential for substantial delays in starting appropriate treatment. Additionally, they report that evidence supports benefit for treatment in adults up to age 65, but that for older adults the evidence is less clear. Therefore, they advise shared decision-making around screening and treatment for anxiety in adults aged 65 years or older.2
In summary, anxiety is a common underdiagnosed condition in all age groups. Screening for anxiety can increase health care satisfaction.
1 US Preventive Services Task Force. Screening for Anxiety in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;328(14):1438–1444. doi:10.1001/jama.2022.16936
2 US Preventive Services Task Force. Screening for Anxiety Disorders in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2023;329(24):2163–2170. doi:10.1001/jama.2023.9301
Information in this article is for general educational purposes and is not intended to establish practice guidelines or provide legal advice.
Article originally published in 1Q24 Copiscope.
