Anxiety disorders are often underrecognized and underdetected in primary care.One study cited by the Task Force found the median time to start treatment for anxiety to be staggering. 23 years old.
While the task force’s initial deliberations on anxiety screening predated the coronavirus pandemic, the new guidance came at a critical time, said task force member and clinical psychologist in Worcester, Massachusetts. said Lori Pubert, a professor at the University of Massachusetts Chang School of Medicine.
“Covid has taken a toll on the mental health of Americans,” said Pbert. “Although this is a topic of high public health importance, it is clear that mental health has become more of a concern in the country in recent years.”
In April, the task force made similar recommendations and started unrest Pediatric and Teenage ScreeningThe proposal, released Tuesday, focuses on young and middle-aged adults, including those who are pregnant or postpartum, and cites research showing that screening and treatment can improve anxiety symptoms in those under 65. .
Somewhat surprisingly, however, this guidance falls short of recommending anxiety screening for people over the age of 65.
One reason is that many of the common symptoms of aging, such as trouble sleeping, pain, and fatigue, can be symptoms of anxiety. The task force said there was not enough evidence to determine the accuracy of screening tools for older adults, and they may not be sensitive enough to distinguish between anxiety symptoms and aging conditions.
The task force advised clinicians to use their judgment when discussing anxiety with older patients. It also reiterated previous recommendations that adults of all ages undergo regular screening for depression.
The Task Force is an independent panel of experts appointed by the Medical Research and Quality Agency and has a great deal of influence. Although its advice is not compulsory, the committee’s recommendations often change the way physicians practice medicine in the United States.
Some doctors wondered how the recommendations would work in the real world. mental health provider They say they are already unable to meet the patient’s demands, and the patient complains of waiting months for an appointment with a therapist.
Eugene Beresin, a psychiatrist at Massachusetts General Hospital, said: Clay Center for Young Healthy Minds.
Global prevalence of anxiety and depression increased by 25% in the first year of the pandemic.who report Earlier this year. By the end of 2021, the WHO said, “Though the situation has improved somewhat, today too many people lack the care and support they need for both existing and new-onset mental health conditions. I am unable to receive the
Anxiety, with its overt fear and physical manifestations such as heart pounding, heart pounding, and palms sweating, is associated with many disorders, including generalized anxiety disorder, social anxiety disorder, and panic disorder. It can present as different diagnoses of
Combine these most common mental illness According to the Anxiety and Depression Association of America, it affects 40 million adults in the United States each year. Treatment includes psychotherapy, especially cognitive-behavioral therapy. Antidepressants or anti-anxiety medications; as well as various relaxation, mindfulness and desensitization therapies, doctors said.
The panel also considered the benefits of screening patients for suicide risk, but concluded that: Although suicide is the leading cause of death among adults, “there is not enough evidence whether screening people without signs or symptoms will ultimately help prevent suicide.”
Nonetheless, the panel called on health care professionals to use independent clinical judgment to determine whether an individual patient should be screened for suicide risk.
Already struggling for primary care physicians “crisis” With burnout, pandemic stress, and their own mental health issues, adding yet another screening test to a long list of clinical tasks can feel overwhelming.
“If the primary care provider were asked to do one more screening, we would be suspended without further resources,” said Kita, who requested anonymity because she did not have permission from the clinic to speak. said a California nurse practitioner. about the problem.
Check off current requirements such as the latest screenings for cervical, colon and breast cancer, food insecurity, domestic violence, and alcohol and tobacco use, all in a 15-minute appointment. she said. Treatment of patients with complex and chronic conditions.
“When people are active with depression and anxiety and there’s no mental health support to help them, it just feels wrong,” the practitioner said.
But Mamuda Qureshi, an internist at Massachusetts General Hospital, said additional support for patients suffering from depression and anxiety can help.
“Post-2020, it’s rare to find a patient who doesn’t feel anxiety.”
Recognizing the challenges of providing mental health care to all in need, the task force added that “less than half of individuals experiencing mental illness have access to mental health care.”
The committee also noted “racism and structural policies” that disproportionately affect people of color. The panel noted that black patients were less likely than other groups to receive mental health services, and that misdiagnosis of mental health conditions occurred more frequently among blacks and Hispanics. Patience.
Pbert said the latest guidance is just one step in addressing patients’ urgent mental health needs. “Our hope is that this set of recommendations will raise awareness of the need to increase access to mental health care across the country,” she said, adding, “By highlighting gaps in the evidence, funding researchers to support much-needed research in these areas.” “
The suggested recommendations are public comment The Task Force will then consider them for final approval.
