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Consider screening adolescent and adult women at least once for anxiety
Question clinique
Should adolescent and adult women be screened for anxiety?
L’Essentiel
Although various screening tools work to identify anxiety in adolescent and adult women, including pregnant and postpartum women, there are no studies that show the benefits or harms of this screening (or its cost). Still, this consortium of representatives from women's health professional organizations and patient representatives recommends screening for anxiety at least once. They do not weigh in on the frequency of screening. They do not weigh in on whether men should be screened. 5
Référence
Plan de l'etude: Practice guideline
Financement: Government
Cadre: Outpatient (any)
Sommaire
The Women's Preventive Services Initiative is a national coalition of 21 health professional organizations and patient representatives, and this guideline on anxiety screening is the first to come from the group. It is based on a systematic review of the evidence of the accuracy of screening tools. However, there is no research to show the benefits or harms of such screening; in other words, whether early identification via screening affects patient-oriented outcomes. The group bases its recommendations on the concept that early identification can improve symptoms, function, or quality of life, a supposition that is only sometimes true for screening procedures. They do not recommend specific screening tools, although they mention that commonly used screening tools are sufficiently accurate (high strength of evidence). The authors do not report significant financial conflicts of interest. The recommendations were graded using the GRADE rubric, and research analysts were involved in the systematic review. The guideline are used as justification of payment for anxiety screening in the United States.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Commentaires
screening
This can get complicated. Another screening tool. How many now?
no evidence
There is no evidence of appropriate patient-centred outcomes...as such, this is an in appropriate recommendation. Please refer to the Canadian Task Force recommendations to NOT screen for depression...as there is no evidence of benefit.
CHRONIC OR UNSPECIFIC PAIN
AS A NEUROSURGEON I SUSPECT ABOUT 1/3 OF MY PATIENT HAS BEEN AFFECTED BY SEVER ANXIETY AND EVEN RESENTMENT IN 3RD PARTY AND THESES ARE THE ONE WITH NORMAL STUDY NON SURGICAL LESION , SEVER ANXIETY AND SEVER PAIN, THEY ARE FRUSTRATED AND DIFFICULT TO TREAD NORMAL DON,T ATTAND FOR TEST THAT THEY INSISTED TO HAVE LIKE MRI , OR SECOND CONSULTANT LIKE NEUROLOGIST AND PHYSICAL MEDICINE SPECIALIST OR PAIN MANAGEMENT CLINIC , BUT STILL ANTI ANXIETY MEDICATION IN THE FORM OF MUSCUL RELAXANT AND NEUROLEPTIC MEDICATION HAS VERY LIMITED EFFECT.
The principles of screening
This intervention does not jive with the principles of screening laid out by Wilson and Jungner. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893317/
screening
Unless there are accessible and affordable resources in place to deal with a problem ( in this case, anxiety ), I do not screen for such problems.
Anxeity
Certainly anxiety is a common issue in younger women more commonly though not exclusively. I suspect it manifests frequently in men as well but perhaps more as abuse of ethanol for socio-cultural reasons, at least in my practice.
Only a short comment required:
What nonsense, really!
No further comment
Evidence of benefit
None