Screening for Anxiety in Children and Adolescents

Abstract

ImportanceAnxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children’s Health found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression.ObjectiveThe US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for anxiety disorders in children and adolescents. This is a new recommendation.PopulationChildren and adolescents 18 years or younger who do not have a diagnosed anxiety disorder or are not showing recognized signs or symptoms of anxiety.Evidence AssessmentThe USPSTF concludes with moderate certainty that screening for anxiety in children and adolescents aged 8 to 18 years has a moderate net benefit. The USPSTF concludes that the evidence is insufficient on screening for anxiety in children 7 years or younger.RecommendationThe USPSTF recommends screening for anxiety in children and adolescents aged 8 to 18 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety in children 7 years or younger. (I statement)

Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study

“…Our study further emphasizes the importance of screening for anxiety as part of the routine evaluation of adolescent children. In our study, we used SCARED, which is a simple tool, widely used as initial screen for anxiety in children [21,29]. Although other questionnaires might be more sensitive, they are more time-consuming.…”

“…Anxiety has been linked to increased sympathetic activation and peripheral vascular resistance, which can lead to hypertension [18][19][20]. Anxiety screening is becoming a standard part of primary care for children and recently the US preventive services task force (USPSTF) recommends screenings for children aged 8-18 years [21]. It is estimated that 15% of children and 30% of adolescents meet the criteria for anxiety [22].…”

Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System

“…Early mental health issue onset also poses risks to long-term quality of life [ 5 , 6 ], as strong evidence links psychosocial problems during youth with poor mental health during adulthood [ 2 , 7 ]. In the United States, screening for depression and suicide risk in adolescents 12–18 years old, is recommended [ 8 ], and for anxiety in ages 8–18 [ 9 ]. Broad screening for mental health issues has potential to lead to better health and prevent unnecessary morbidity and mortality [ 10 ].…”

Residential background as a vulnerability factor for adolescent anxiety in China: A multiwave longitudinal study.

“…The results of epidemiological studies suggest that the prevalence of anxiety has risen in many countries in recent years (Ouimet et al, 2009). More specifically, the 2020 National Survey of Children’s Health estimated that 7.8% of children aged 3–17 years had a current anxiety disorder (Mangione et al, 2022). A longitudinal study in the United States found that the predicted cumulative prevalence of any anxiety disorder by the age of 16 years was 9.9% (Yen et al, 2010).…”