Screen Kids 8 and Older for Anxiety, Expert Panel Recommends

Children aged 8 and up should be screened foranxiety, the influential U.S. Preventive Services Task Force (USPSTF) recommended on Tuesday. Kids aged 12 and up should also be screened fordepression, the task force advised.

This is the first time the task force has recommendedanxietyscreening for young children. Thedepression建议是一样的特遣部队的问题d in 2016.

TheJournal of the American Medical Association(JAMA)published the USPSTF recommendations Oct 11.

“The Task Force reviewed the evidence on screening foranxiety,depression, andsuiciderisk to provide primary care professionals with guidance on how they can help support themental healthof children and adolescents,” member Martha Kubik, a professor with the School ofNursingin the College of Health and Human Services at George Mason University, said in a USPSTF statement.

“Fortunately, screening older children foranxietyanddepressioncan identify these conditions so children andteenscan receive the care that they need,” Kubik added.

The new recommendations apply to children who are not already diagnosed with amental healthcondition and who don't have recognized symptoms ofanxietyordepression.

“The 2018-2019 National Survey ofChildren's Health(NSCH) found that 7.8% of children and adolescents aged 3 to 17 years had a currentanxiety disorder.Anxietydisorders in childhood and adolescence are associated with an increased likelihood of futureanxiety disorderordepression,” the experts noted in their recommendation.

"Too many children andteensin the United States experience mental health conditions, includinganxiety,depression, andsuicidal thoughtsor behaviors," the panel added in their statement. "There are several forms ofanxiety, includinggeneralized anxiety disorderand social anxiety, but all forms are characterized by excessive fear or worry."

The recommendation on anxiety is in line with those the task force preliminarily recommended for adults under age 65.

Speaking in the USPSTF statement, panel member Lori Pbert said that the recommendation was prioritized “because of its public health importance, especially with the increased focus on mental health in this country that we've been having for the past few years.” Pbert is a clinical psychologist and professor at the University of Massachusetts Chan Medical School in Worcester, Mass.

Although the task force considered a recommendation on screening forsuiciderisk in children and adolescents, it decided not to go forward with that. Members decided there was not enough evidence on the harms and benefits ofsuicidescreening in this age group.

The task force also did not make recommendations for anxiety ordepressionscreening for even younger children, citing a lack of evidence.

“The Task Force cares deeply about the mental health of all children and adolescents. Unfortunately, there are key evidence gaps related to screening for anxiety and depression in younger children and screening forsuiciderisk in all youth,” Pbert explained. “We are calling for more research in these critical areas so we can provide health care professionals with evidence-based ways to keep their young patients healthy.”

In an editorial published alongside the recommendations, doctors from the Ann and Robert H. Lurie Children's Hospital, Weill Cornell Medicine and the University of Cincinnati called the recommendations to screen “very good news.” Most psychiatric disorders, including anxiety, begin during childhood and adolescence, they noted.

“Screening in the pediatric primary care setting is important for early identification and offers the potential for earlier and more effective treatment to reduce distress, impairment, and morbidity associated with delayed recognition and treatment,” the editorial said.

SLIDESHOW

A Visual Guide to Generalized Anxiety DisorderSee Slideshow

The writers noted that the evidence report does not give specific guidance for how screening should happen in primary care settings.

“While future research efforts are needed to address the gaps in the evidence base, the available evidence appears to support moving forward with implementing screening and treatment for anxiety disorders in pediatric primary care settings,” they wrote.

波士顿儿童Hosp奥斯卡Bukstein博士ital also wrote an editorial published Tuesday inJAMA. Bukstein said the recommendations suggest there are many more questions to be asked than can be answered with current evidence.

“Suicidalbehavior is among the most critical of medical emergencies for adolescents,” and screening for suicide is the “cornerstone of suicideprevention,” Bukstein wrote.

“It is not coincidental that the USPSTF considered evidence for suicide and depression screening in the same updated Evidence Report and Systematic Review,” he wrote. “Given the salience of depression as a risk factor forsuicidalbehavior and the value of depression screening as supported by the USPSTF recommendation, screening for suicide under the umbrella of depression screening could accomplish both screening tasks at the same time.”

SOURCES:Journal of the American Medical Association,Oct. 11, 2022; Statement, U.S. Preventive Services Task Force, Oct. 11, 2022

By Cara Murez HealthDay Reporter

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