Recently the U.S. Preventive Services Task Force recommended anxiety screening for people ages 8 to 65 years. Is this a helpful recommendation or not?

Anxiety disorders are the most prevalent psychiatric diagnosis. Anxiety can be a disabling condition. Treatment is commonly by medications such as SSRIs. Talk therapies are helpful, but not frequently prescribed. Psychodynamic and CBT therapies can be used along with hypnosis, techniques for relaxation and guided imagery.

If we screen more for anxiety disorders and find them, then we must treat more people. Can we do this? What treatments can we offer via the already-overburdened mental health care system?

Psychiatrist Robert T. London sees several drawbacks to and voices concerns about universal anxiety screening. One is the exclusion of those over 65 years of age; the task force cited a “lack of data” regarding this cohort. London points out that the older age group has many worries, including those associated with aging itself––health problems, retirement, deaths of friends and relatives, and financial concerns.

London also points out that most anxiety screening is and will continue to be done by primary care physicians. They do quick, few-minute evaluations and prescribe medications. No in-depth mental health evaluation is possible with such time constraints.

Most anxiety screening is not done by psychiatrists or psychologists. Such specialists are not readily available in sufficient numbers for necessary in-depth diagnosis and treatment planning beyond medications given by PCPs.

To better understand the prevalence of anxiety we need to look at two questions: whether anxiety disorders have increased in the last 50-100 years and/or whether people’s ability to cope has diminished, or whether both have occurred.

If anxiety has increased, what is the reason? Better diagnostic tools and acumen? Decreased ability to cope with life’s ups and downs?........

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