TY - JOUR
T1 - Screening for anxiety in adolescent and adult women
T2 - A recommendation from the women's preventive services initiative
AU - Gregory, Kimberly D.
AU - Chelmow, David
AU - Nelson, Heidi D.
AU - Van Niel, Maureen Sayres
AU - Conry, Jeanne A.
AU - Garcia, Francisco
AU - Kendig, Susan M.
AU - O'Reilly, Nancy
AU - Qaseem, Amir
AU - Ramos, Diana
AU - Salganicoff, Alina
AU - Son, Sarah
AU - Wood, Julie K.
AU - Zahn, Christopher
N1 - Funding Information:
The Women's Preventive Services Initiative (WPSI) is a national coalition of 21 health professional organizations and patient representatives that develops, reviews, updates, and disseminates evidence-based clinical recommendations for women's preventive health care services in the United States (20). The WPSI considers conditions that are unique to, more common in, or different in women. The WPSI is supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services and led by the American College of Obste- tricians and Gynecologists. Methods and processes of the WPSI and persons involved are detailed on a website (21) and in previous publications (22). The Appendix (available at Annals.org) lists current members and their organizations.
Publisher Copyright:
© 2020 American College of Physicians. All rights reserved.
PY - 2020/7/7
Y1 - 2020/7/7
N2 - Description: The Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives, developed a recommendation on screening for anxiety in adolescent and adult women to improve detection; achieve earlier diagnosis and treatment; and improve health, function, and well-being. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders. The target audience for this recommendation includes all clinicians providing preventive health care to women, particularly in primary care settings. This recommendation applies to women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Methods: The WPSI developed this recommendation after evaluating results of a systematic review of the effectiveness of screening, accuracy of screening instruments, and benefits and harms of treatments in adolescent girls and adult women. No studies directly evaluated the overall effectiveness or harms of screening for anxiety. Twenty-seven screening instruments and their variations were moderately to highly accurate in identifying anxiety (33 individual studies and 2 systematic reviews; 171 studies total). Symptoms improved and relapse rates decreased with psychological therapies (246 randomized controlled trials [RCTs] in 5 systematic reviews) and with selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors (126 RCTs in 3 systematic reviews). The WPSI also considered the effect of screening on symptom progression and identification of associated and underlying conditions, as well as implementation factors. Recommendation: The WPSI recommends screening for anxiety in women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Optimal screening intervals are unknown, and clinical judgment should be used to determine frequency. When screening suggests the presence of anxiety, further evaluation is necessary to establish the diagnosis and determine appropriate treatment and follow-up.
AB - Description: The Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives, developed a recommendation on screening for anxiety in adolescent and adult women to improve detection; achieve earlier diagnosis and treatment; and improve health, function, and well-being. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders. The target audience for this recommendation includes all clinicians providing preventive health care to women, particularly in primary care settings. This recommendation applies to women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Methods: The WPSI developed this recommendation after evaluating results of a systematic review of the effectiveness of screening, accuracy of screening instruments, and benefits and harms of treatments in adolescent girls and adult women. No studies directly evaluated the overall effectiveness or harms of screening for anxiety. Twenty-seven screening instruments and their variations were moderately to highly accurate in identifying anxiety (33 individual studies and 2 systematic reviews; 171 studies total). Symptoms improved and relapse rates decreased with psychological therapies (246 randomized controlled trials [RCTs] in 5 systematic reviews) and with selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors (126 RCTs in 3 systematic reviews). The WPSI also considered the effect of screening on symptom progression and identification of associated and underlying conditions, as well as implementation factors. Recommendation: The WPSI recommends screening for anxiety in women and adolescent girls aged 13 years or older who are not currently diagnosed with anxiety disorders, including pregnant and postpartum women. Optimal screening intervals are unknown, and clinical judgment should be used to determine frequency. When screening suggests the presence of anxiety, further evaluation is necessary to establish the diagnosis and determine appropriate treatment and follow-up.
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U2 - 10.7326/M20-0580
DO - 10.7326/M20-0580
M3 - Article
C2 - 32510990
AN - SCOPUS:85088206828
SN - 0003-4819
VL - 173
SP - 48
EP - 56
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 1
ER -