Anxiety screening for kids should begin at age 8, experts say

Oct. 11 (UPI) -- An panel of experts on Tuesday separately issued two recommendations that target anxiety and depression in children and adolescents.

One suggests screening for anxiety in youth ages 8 to 18, and the other urges screening for major depressive disorder in adolescents ages 12 to 18.

The task force statements on anxiety and depression screenings for adolescents were published in JAMA, the Journal of the American Medical Association.

The experts, comprising the U.S. Preventive Services Task Force, said primary-care screening can help identify anxiety and depression in older children and teens who are not showing signs or symptoms of these conditions.

But the panel stopped short of recommending such screenings in younger children, saying the current evidence is insufficient to support that and called for further research.

The group also found insufficient evidence to recommend for or against screening for suicide risk in children and adolescents. It came to a similar conclusion in 2014.

"While suicide is tragically the leading cause of death in older children and teens, there continues to be limited evidence about screening for suicide risk across all ages in those who do not have recognized symptoms," the panel said.

It cited the urgent need for further research, though.

The panel, in a news release, underscored its concern that "too many children and teens in the United States experience mental health conditions like anxiety, depression, and suicidal thoughts or behaviors."

Task force member Lori Pbert, a clinical psychologist, said in the release that the panel "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 for suicide risk in all youth," she said.

"We are calling for more research in these critical areas so we can provide healthcare professionals with evidence-based ways to keep their young patients healthy."

The aim is to get primary care clinicians to use already existing, effective screening tools to help children and adolescents with "prevalent and challenging" mental health conditions get the care they need before the situation worsens, task force member Martha Kubik, professor of nursing at George Mason University School of Nursing in Fairfax, Va., told UPI in a phone interview.

Kubik, a registered nurse, said the panel's recommendations represent important progress "to intervene around mental health conditions and facilitate a next step -- because screening is not a diagnosis. It's a first step ... to confirm diagnosis and connect with care."

She added: "We're saying, 'Move these tools forward.'"

Kubik also cautioned that if a child's parent or caregiver has concerns, "that is not a screening situation and requires more immediate evaluation."

The anxiety recommendation is new, while the task force said the recommendation on screening for major depression is consistent with its 2016 statement.

According to the panel, anxiety disorder is a common mental health condition in the United States, comprising a group of related conditions characterized by excessive fear or worry that may appear as emotional and physical symptoms.

The task force cited a 2018-2019 survey that found 7.8% of children and adolescents ages 3 to 17 had a current anxiety disorder.

The panel noted that anxiety disorders in childhood and adolescence are are linked to a higher likelihood of adult anxiety disorder or depression.

Similarly, the task force said major depressive disorder in children and adolescents is "strongly associated with recurrent depression in adulthood, other mental disorders, and increased risk for suicidal ideation, suicide attempts" and actual suicide.

In February, the American Academy of Pediatrics issued updated guidelines that urged annual depression screening for all young people ages 12 to 21.

At the time, the group said only about 50% of adolescents with depression are diagnosed before reaching adulthood and as many as 2 in 3 depressed teens don't receive care.