Task Force Recommends Anxiety, Depression Screenings for Children

Screening at a young age is important because the majority of psychiatric disorders start during childhood and adolescence. In this Healthline article, Mindpath Health’s Zishan Khan, MD, explains why it is more important than ever to screen children for anxiety and depression.

The U.S. Preventive Services Task Force (USPSTF) is recommending two new mental health screenings for children.

The independent panel of national experts said children 12 to 18 years old should be screened for depression and suicide risk. It also recommends children 8 to 18 be screened for anxiety.

The task force describes anxiety disorder as “a common mental health condition in the United States” that is comprised of a group of related conditions characterized by excessive fear or worry. They said the condition produces both emotional and physical symptoms.

Task force members noted that the 2018-2019 National Survey of Children’s Health found that nearly 8 percent 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,” members of the task force wrote.

The USPSTF study concluded with “moderate certainty” screening for anxiety in children 8 to 18 years old “has a moderate net benefit.”

The group said evidence is insufficient on screening for anxiety in children younger than 8 and for depression in children younger than 12.

The task force noted that depression is a leading cause of disability in the United States. They said children and adolescents with depression typically have functional impairments in their performance at school or work and during interactions with their families and peers.

”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 suicide completion,” they wrote.

Suicide is the second-leading cause of death among youth aged 10 to 14 years.

The importance of screenings

“There is definitely a growing concern for mental health issues among children,” Dr. Zishan Khan, a child, adolescent, and adult psychiatrist with Texas-based Mindpath Health, told Healthline.

Khan said screenings are important because the signs of both depression and anxiety can be subtle.

“People with depression can present with isolative behavior, an intense feeling of fatigue, having a lack of energy or motivation to participate in activities they normally enjoy, sleeping and/or eating more or less than usual, and even with anger outbursts,” Khan said.

“Children who are anxious will often ruminate continuously, often about things most kids their age wouldn’t worry about. They may have fears about their loved ones, activities they participate in, and school, or even irrational fears about death or being separated from their family,” he added.

Anxiety can present itself with stomach pains, headaches, or generalized weakness “which are actually somatic manifestations of their anxiety,” Khan said.

Screening at a young age is important because the majority of psychiatric disorders start during childhood and adolescence, Pardis Khosravi, PsyD, a psychologist and clinical director at Palo Alto-based Children’s Health Council, told Healthline.

“Universal screening for anxiety starting at age 8 and depression by age 12 ensures that we are catching individuals during the ages where they are more likely to be developing these challenges,” Khosravi said.

More important than ever now

Experts said mental health screenings are especially important now with the lingering effects of the COVID-19 pandemic still present.

“The research is always evolving, and we are always learning more about the impact of anxiety and depression on children; however, the increase in the number of youth struggling with anxiety and/or depression is staggering,” Khosravi said. “Before the COVID-19 pandemic, an estimated 1 in 5 children ages 3 to 17 in the U.S. struggled with having a mental, emotional, developmental, or behavioral disorder, with anxiety and depression being the most common psychiatric disorders in youth. That number has skyrocketed since the pandemic.”

It’s possible adults have historically underestimated the effect of depression and anxiety on youth, but there’s also more modern pressure through other relatively new factors such as social media, experts said.

“We continue to improve upon our understanding and conceptualization of depression and anxiety in kids,” Rebecca Kamody, Ph.D., a clinical psychologist at Yale New Haven Children’s Hospital in Connecticut, told Healthline. “As a result, we are better able to accurately identify depressive and anxiety-related symptoms in kids, when historically we may have missed these symptoms.”

“Current cultural and environmental stressors have significantly impacted the risk of developing depression and anxiety in youth, further illustrating the importance of early screening and intervention to prevent escalation of severity of symptoms,” she added.

Experts say standard screenings can be – and are often easiest – done in the office of a child’s regular pediatrician, where a familiar face can help guide the process and offer possible referrals to other clinicians, if necessary. The screenings can also be done through school-based and community clinics

“It’s fantastic that we’ll be completing these screenings and identifying more children who need mental health services,” Cameron Mosley, Ph.D., a licensed psychologist and clinician for Anxiety Specialists of Atlanta, told Healthline. “Of course, this does not change the fact that there are already not enough providers to meet the mental health needs of the population. Just identifying these children will not guarantee that their needs are addressed.”

“We have a long way to go before all children will have access to affordable, evidence-based mental health care,” she added.

Read the full Healthline article with sources.