This is a B recommendation, stemming from adequate evidence that screening tools can accurately identify anxiety in this population and moderate evidence that efficacious treatments exist. In a new Recommendation Statement 8 in this issue of JAMA, the USPSTF now recommends, based on an accompanying Evidence Report, 9 that all adults aged 18 to 64 years be screened for anxiety. 6 The US Preventive Services Task Force (USPSTF) recently recommended screening for anxiety in children aged 7 to 18 years, 7 but it is too early to know the extent to which these guidelines are being implemented and far too early to know if they have had a positive impact. 5 There are also 2 anxiety disorders that are encountered predominantly, though perhaps not exclusively, in pediatric settings: selective mutism and separation anxiety disorder. 4 The latter 2 instances of anxiety are caused by identifiable and, mostly, treatable sources and should be considered “rule-outs” before concluding that one of the other anxiety disorders is present.Īnxiety disorders typically have onset early in life, hence the importance of screening for anxiety in children and adolescents when there is the opportunity to promptly intervene and prevent what can often be lifelong impairment. 2, 3 The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5) recognizes the following types of anxiety disorders likely to be seen in adults: generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobias, substance/medication-induced anxiety disorder, and anxiety disorder due to another medical condition. 1 Anxiety disorders are characterized by anxious mood and, often, phobic avoidance, which result in extreme distress, functional impairment, or both. Mental disorders are a leading cause of disease burden worldwide, with anxiety disorders being the second most influential contributor, after depressive disorders, to global disability-adjusted life-years. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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