Adults under the age of 65 should be screened for anxiety disorders and all adults should be checked for depression, a government-backed panel said, as many Americans report symptoms of these mental-health conditions following the height of the Covid-19 pandemic.
The draft guidance released Tuesday marks the first time that the United States Preventive Services Task Force has made a recommendation on screening adults for anxiety disorders. The move comes months after the task force issued similar draft guidance for children...
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Adults under the age of 65 should be screened for anxiety disorders and all adults should be checked for depression, a government-backed panel said, as many Americans report symptoms of these mental-health conditions following the height of the Covid-19 pandemic.
The draft guidance released Tuesday marks the first time that the United States Preventive Services Task Force has made a recommendation on screening adults for anxiety disorders. The move comes months after the task force issued similar draft guidance for children and adolescents.
“This is a really important step forward,” said Arthur C. Evans, chief executive at the American Psychological Association. “Screening for mental-health conditions is critical to our ability to help people at the earliest possible moment.”
The task force said that there wasn’t enough evidence on whether or not screening all adults without signs or symptoms ultimately helps prevent suicide. The group didn’t recommend for or against screening for suicide risk, but called for more research in the area.
The task force, a panel of 16 independent volunteer experts, issues guidance on preventive-care measures. Health insurers are often required to cover services recommended by the task force under a provision in the Affordable Care Act.
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More than 30% of adults reported having symptoms of an anxiety disorder or depressive disorder this summer, according to estimates from the federal Household Pulse Survey. The percentage of U.S. adults who received mental-health treatment within the past 12 months increased to 22% in 2021, up from 19% in 2019, according to the Centers for Disease Control and Prevention.
Mental-health screening often occurs in doctor’s offices, where patients fill out questionnaires during routine checkups or other appointments. The goal is to spot at-risk people who might not be showing obvious signs, so that the person can get the correct diagnosis and potentially get connected to care before they reach a crisis point.
The surveys ask patients about how often they feel depressed or hopeless, have trouble with sleep fatigue or appetite, have thoughts of harming themselves, or how often they are unable to control their worrying, on a scale ranging from not at all to nearly every day.
Delving into the results together can help some patients open up who otherwise might not be as forthcoming about their mental health, said Riza Conroy, a primary-care physician at Ohio State University.
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“It helps me get a better idea about whether their insomnia is really pure insomnia or if it is part of depressive symptoms,” Dr. Conroy said.
But widespread screening can also yield false-positive results, potentially leading to overdiagnosis and unnecessary treatment that comes with side effects, as well as unease and stigma, the task force and other mental-health experts said. In the U.K., the UK National Screening Committee didn’t recommend depression screening after a 2020 review, in part due to the potential for false positives.
“You end up with a score that you feel you have to act on,” said Stephanie Collier, a psychiatrist at McLean Hospital and a consulting psychiatrist for the Population Health Management Team at Newton-Wellesley Hospital in Massachusetts, who wasn’t involved with the new guidance.
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To inform the new recommendations, task-force members reviewed evidence from some 173 studies that looked at screening-test accuracy and the effectiveness of available interventions for depression, anxiety disorders and suicide risk. A few studies looked at the direct impacts of the screening itself on health outcomes.
The task force concluded that screening all adults for depression, including those who are pregnant or postpartum as well as older adults, has a moderate net benefit, echoing its previous 2016 recommendations. The task force also recommended screening adults under 65, including pregnant and postpartum people, for anxiety but said that there wasn’t enough evidence to make the same recommendation for older adults.
Some anxiety-disorder screening questionnaires emphasize issues with sleep, pain and fatigue, which also often increase with age, said Lori Pbert, task-force member and professor in the department of population and quantitative health sciences at UMass Chan Medical School.
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“You could be flagging a lot of older adults for having an anxiety disorder when they don’t,” Dr. Pbert said.
Dr. Pbert said that there also wasn’t enough evidence to make a recommendation for or against suicide screening. The adult suicide rate in the U.S. peaked in 2018 but has increased some 30% overall over the past two decades.
“It’s on the top of mind for many of us,” Dr. Pbert said.
In April, the task force received some pushback for its lack of recommendation for suicide screening among adolescents. The American Foundation for Suicide Prevention sent a letter to the task force in May, asking them to re-examine the body of evidence.
“It could present a threat to forward progress in preventing suicide at a time when it’s clearly showing up as a national health crisis,” said Christine Yu Moutier, chief medical officer at the American Foundation for Suicide Prevention.
In the absence of evidence, healthcare providers should use their clinical judgment for each individual patient to determine whether or not to screen for suicide, said Gbenga Ogedegbe, a task-force member and professor of medicine and population health at the NYU Grossman School of Medicine.
The recommendations are drafts that will be open for comment on the task-force website through Oct. 17, after which the task force will issue its completed guidance.
Write to Brianna Abbott at brianna.abbott@wsj.com