U.S. Preventive Services Task Force (USPSTF) Bulletin
WASHINGTON, D.C. – September 20, 2022 – The U.S. Preventive Services Task Force (Task Force) today posted draft recommendation statements on screening for depression and suicide risk in adults and screening for anxiety in adults. For the first time, the Task Force is recommending screening adults
younger than 65 for anxiety. This is a B grade. The Task Force continues to recommend screening all adults, including those who are pregnant and postpartum, for depression. This is a B grade. There is not enough evidence to recommend for or against screening for suicide risk in all adults or screening for anxiety in adults age 65 or older. These are I statements. These draft recommendations are only for people without recognized signs or symptoms of these conditions.
Anxiety and depression, and suicidal thoughts or behaviors, are mental health conditions affecting the lives of many adults in the United States. There are several forms of anxiety, including generalized anxiety disorder and social anxiety, but all forms are characterized by excessive fear or worry. Depression, or major depressive disorder, is a condition that negatively affects how people feel, think, and act. Depression can also occur during pregnancy or up to one year after childbirth; this is known as perinatal depression.
“To address the critical need for supporting the mental health of adults in primary care, the Task Force reviewed the evidence on screening for anxiety, depression, and suicide risk,” says Task Force member Lori Pbert, Ph.D. “The good news is that screening all adults for depression, including those who are pregnant and postpartum, and screening adults younger than 65 for anxiety can help identify these conditions early so people can be connected to care.”
For most adults, screening and followup care can reduce symptoms of anxiety and depression. However, there is limited evidence on the benefits and harms of screening adults 65 or older for anxiety. More research is also critically needed on the role of screening for suicide risk. Although suicide is tragically a leading cause of death among adults, there is not enough evidence on whether screening those without recognized signs or symptoms helps prevent suicide.
“The Task Force cares deeply about the mental health of people nationwide. Unfortunately, evidence is limited on screening adults 65 or older for anxiety and screening all adults for suicide risk, so we are urgently calling for more research,” says Task Force member Gbenga Ogedegbe, M.D., M.P.H. “In the absence of evidence, healthcare professionals should use their judgment based on individual patient circumstances when determining whether or not to screen.”
The Task Force recognizes that screening is only the first step in helping adults with anxiety and depression. People who screen positive need further evaluation to determine if they have anxiety or depression. After diagnosis, people should participate in shared decision making with their healthcare professionals to identify the treatment or combination of treatments that are right for them, and then be monitored on an ongoing basis to ensure that the chosen treatment is effective. It is important to underscore that these recommendations only apply to people without recognized signs or symptoms of these conditions. It is essential that healthcare professionals connect any individual who expresses concerns about anxiety, depression, or suicide or reports symptoms of these conditions to appropriate care.
The Task Force’s draft recommendation statements and draft evidence review have been posted for public comment on the Task Force website at www.uspreventiveservicestaskforce.org. Comments can be submitted from September 20, 2022, to October 17, 2022, at www.uspreventiveservicestaskforce.org/tfcomment.htm.
The Task Force is an independent, volunteer panel of national experts in prevention and evidence–based medicine that works to improve the health of people nationwide by making evidence–based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.
Dr. Pbert is a professor in the Department of Population and Quantitative Health Sciences, associate chief of the Division of Preventive and Behavioral Medicine, and founder and director of the Center for Tobacco Treatment Research and Training at the UMass Chan Medical School.
Dr. Ogedegbe is the inaugural and founding director of the Institute for Excellence in Health Equity at NYU Langone Health. He is the Dr. Adolph and Margaret Berger Professor of Medicine and Population Health at NYU Grossman School of Medicine. Dr. Ogedegbe is a member of the National Academy of Medicine.
Contact: USPSTF Media Coordinator at Newsroom@USPSTF.net / (301) 951–9203