Routine screening for depression in adults is recommended by the US Preventive Services Task Force, but there are no current screening recommendations for anxiety in women who, according to the Women's Preventive Services Initiative (WPSI), experience a prevalence of anxiety disorders at a rate at nearly twice that of men. Now though, WPSI, a federally funded national coalition of health organizations led by the American College of Obstetricians and Gynecologists, recommends that primary care doctors issue anxiety screenings for females started from age 13, including pregnant and postpartum women.
This recommendation, published in the Annals of Internal Medicine on June 9, was made in order promote earlier detection of anxiety disorders and conditions that occur alongside them such as depression and PTSD, and therefore initiate further evaluation of diagnosis and the appropriate treatment (psychotherapy and medication, for instance). Heidi Nelson, MD, MPH, one of the authors of the report and a professor at Oregon Health & Science University School of Medicine, told NPR, "Anxiety lives under the surface and can be very disabling, but it's not easily picked up by clinicians. By asking a few questions, we have the ability to help people in a way that's not possible unless we actually ask."
Screening for anxiety, WPSI stated, can be done quickly using questionnaires that the doctor or patient fills out. WPSI suggests that doctors consider screening during annual visits and they should consider screening for anxiety at the same time that they do so for depression because of how often the two co-occur (almost 50 percent of those diagnosed with depression are also diagnosed with an anxiety disorder, according to the Anxiety and Depression Association of America).
Examples WPSI gives for screening tools include the following: "the Patient Health Questionnaire–4 for anxiety and depression and the Hospital Anxiety and Depression Scale in adult women, the Edinburgh Postnatal Depression Scale in pregnant and postpartum women, and the Bright Futures Pediatric Symptom Checklist–Youth Report in adolescents and young women."
WPSI notes that more research needs to be done to evaluate the frequency of screening as well as its benefits and potential harms. "Because anxiety disorders can be successfully treated, early detection through the use of a brief questionnaire could prevent years of symptoms and impairment in the lives of women at every stage of life," the published report concludes.
The recommendation is important to consider especially due to the fact that anxiety disorders can worsen at times of hormonal fluctuations during puberty, pregnancy, postpartum, and menopause. Plus, Dr. Nelson said that instances of sexual harassment and assault, as well as societal pressures in general, can put women at a greater risk for anxiety.