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USPSTF 2023: Screening recommended for anxiety in adults, including in pregnant and postpartum persons (B recommendation)
Clinical Question
Should primary care clinicians screen asymptomatic adults for anxiety disorders?
Bottom line
In this first-time evidence review, the USPSTF recommends screening for anxiety disorders in asymptomatic adults, 19 to 64 years, including pregnant and postpartum persons (B recommendation). The task force further concludes that evidence is insufficient to assess the balance of benefits and harms of screening for anxiety disorders in adults 65 years or older (I statement). As with depression screening, it is important that persons who screen positive are evaluated further and, if appropriate, provided or referred for appropriate treatment. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Various (guideline)
Synopsis
The US Preventive Services Task Force (USPSTF) found no direct evidence showing a benefit in screening for anxiety disorders. The Generalized Anxiety Disorder (GAD) screening instruments demonstrated adequate accuracy for detecting anxiety disorders and sufficient evidence supports the benefit of treatment. No direct evidence of harms from screening was found, thus supporting an overall moderate net benefit to screening. The accuracy of screening instruments for anxiety in older adults is less certain as is evidence that treatment can improve outcomes in screen-detected persons 65 years or older. The task force makes no recommendation on the frequency of screening for anxiety.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
Impact assessment
Excellent
SCREENING ANXIETY IN ADULT PATIENTS
GOOD TO KNOW
USPSTF 2023 recomended screening for anxiety in adults.
The US Preventive Services Task Force found no direct evidence showing a benefit in screening for anxiety disorders. Nonetheless, the Task Force recommended screening for anxiety. There is no logic behind this recommendation.
Screening for anxiety
If there seem to be no benefits and no risks to screening, why would we call this a B recommendation?