Diagnostic accuracy moderate to high for screening for anxiety; CBT and antianxiety meds beneficial
TUESDAY, June 9, 2020 (HealthDay News) -- Screening for anxiety is recommended for women and adolescent girls, according to a review and clinical guideline published online June 9 in the Annals of Internal Medicine.
Heidi D. Nelson, M.D., M.P.H., from the Oregon Health & Science University in Portland, and colleagues conducted a systematic review to examine evidence on the effectiveness of screening for anxiety disorders in primary care, harms of screening, accuracy of screening instruments, and effectiveness and harms of treatments. Data from 33 studies and two systematic reviews assessed the diagnostic accuracy of 27 screening instruments and their variations against a clinical diagnosis or other tools. The researchers found that most instruments demonstrated moderate-to-high accuracy for adults, pregnant and postpartum women, and adolescents. Cognitive behavioral therapy and antianxiety medications improved anxiety symptoms.
Based on these results, Kimberly D. Gregory, M.D., M.P.H., from Cedars-Sinai Medical Center in Los Angeles, and colleagues developed guidelines for anxiety screening for the Women's Preventive Services Initiative (WPSI). The WPSI recommends anxiety screening for women and adolescent girls aged 13 years and older, including pregnant and postpartum women. The optimal intervals for screening are unknown, and to determine frequency, clinical judgement should be used. Further evaluation is necessary to establish diagnosis and determine appropriate treatment after screening indicates the presence of anxiety.
"Tools like the WPSI screening recommendations directed toward vulnerable groups are great first steps but only one of the many elements needed to address mental health crises," write the authors of an accompanying editorial.
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Clinical Guideline
Editorial (subscription or payment may be required)