USPSTF to recommend depression screening for all, and anxiety screening for adults below 65
USA: The US Preventive Services Task Force (USPSTF) has recently released a draft recommendation, in which it has recommended screening for anxiety and depression in adults, including pregnant and postpartum persons, and depression screening in older adults. The USPSTF draft recommendation statement published online on September 20, is not final and will now enter a public comment period.
For depression, the USPSTF concludes that the current evidence is not sufficient to assess the balance of benefits and harms of screening for suicide risk in the adult population, including pregnant and postpartum persons as well as older adults.
For anxiety, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in older adults.
This recommendation, when published, will replace the 2014 USPSTF recommendation statement on screening for suicide risk in adults and the 2016 recommendation statement on screening for major depressive disorder (MDD) in adults.
Elizabeth O'Connor, Kaiser Permanente Evidence-based Practice Center, Portland, Oregon, and associates reviewed the harms and benefits of screening and treatment for anxiety, depression, and suicide risk among primary care patients. Data from 173 studies (consisting of approx. 8.5 million persons) were included.
The researchers found the following:
- Depression screening interventions were linked with reduced prevalence of depression or clinically important depressive symptomatology after six to 12 months (odds ratio, 0.60).
- A large body of evidence supported the benefits of pharmacologic and psychological treatment of depression.
- Two screening studies showed no benefit for anxiety screening.
- A large body of evidence was found supporting the benefit of anxiety treatment.
The two recommendation statements were formulated based on these findings. The USPSTF recommends screening for depression in the adult population, including pregnant and postpartum persons as well as older adults (Grade B). However, it stated that the current evidence is not adequate to assess the balance of benefits and harms of screening suicide risk (I statement).
The USPSTF recommends anxiety screening for adults aged 64 years and younger, including pregnant and postpartum persons (B grade). The current evidence is not sufficient to assess the benefits and harms of anxiety screening in adults aged 65 years and older (I statement).
About Depression
Major depressive disorder (MDD) is a common mental disorder that can substantially affect an individual's life. If not treated on time, it can lead to exacerbation of comorbid conditions, increased risk of cardiovascular events, or increased mortality. Also, depression is a common problem in postpartum and pregnant persons and impacts both the parent and the infant. Depression during pregnancy increased the risk of low birth weight and preterm birth. Postpartum depression may hamper parent-infant bonding.
About Anxiety
Anxiety disorders are mental health conditions that occur commonly. Anxiety disorders include social anxiety disorder, generalized anxiety disorder, separation anxiety disorder, panic disorder, selective mutism, and phobias. Anxiety can be a chronic condition characterized by periods of recurrence and remission. However, full recovery may occur.
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