- A federal task force recommends routine screening of children for anxiety and depression.
- Task force members say children ages 12 to 18 should be screened for depression, while children ages 8 to 18 should be screened for anxiety.
- Experts say this type of screening is becoming increasingly important with the influx of social media and the aftermath of the COVID-19 pandemic.
The US Preventive Services Task Force (USPSTF) recommends two new investigations into children’s mental health.
The independent panel of national experts said children aged 12 to 18 should be screened
The task force describes anxiety disorder as “a common mental illness in the United States” consisting of a group of related disorders characterized by excessive anxiety 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 ages 3 to 17 had a current anxiety disorder.
“Anxiety disorders in childhood and adolescence are associated with an increased likelihood of future anxiety disorder or depression,” task force members write.
The USPSTF study of anxiety in children ages 8 to 18, which concluded with “moderate certainty”, “has a moderate net benefit”.
The group said the evidence for screening for anxiety in children under 8 and for depression in children under 12 is insufficient.
The task force found that depression is a leading cause of disability in the United States. They said that 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 an increased risk of suicidal ideation, suicide attempts, and suicide completion,” they wrote.
Suicide is the
“There is definitely a growing concern about mental health issues in children,” said Dr. Zishan Khan, a child, adolescent and adult psychiatrist at Mindpath Health in Texas, told Healthline.
Khan said screenings are important because the signs of both depression and anxiety can be subtle.
“People with depression may present with isolated behavior, an intense feeling of fatigue, a lack of energy or motivation to engage in activities they usually enjoy, sleeping and/or eating more or less than usual, and even outbursts of anger” said Khan said.
“Anxious children are often constantly brooding over things that most children their age would not think about. They may have fears for loved ones, activities they participate in and school, or even irrational fears of death or separation from their families,” he added.
Anxiety can show up as abdominal pain, headaches, or general weakness, “which are actually somatic manifestations of their anxiety,” Khan said.
Screening at an early age is important because most psychiatric disorders begin in childhood and adolescence, Pardis Khosravi, PsyD, psychologist and clinical director of the Palo Alto-based Children’s Health Council, told Healthline.
“Universal screening for anxiety from age 8 and for depression from age 12 ensures we are enrolling individuals at the age when they are more likely to develop these challenges,” Khosravi said.
Experts said mental health screening is especially important now that the ongoing effects of the COVID-19 pandemic are still in place.
“Research is constantly evolving and we are learning more and more about the effects of anxiety and depression on children; However, the increase in the number of youth struggling with anxiety and/or depression is overwhelming,” Khosravi said. “Prior to the COVID-19 pandemic, an estimated 1 in 5 children ages 3 to 17 in the United States were struggling with a mental, emotional, developmental, or behavioral disorder, with anxiety and depression being the most common psychiatric disorders in adolescents. That number has skyrocketed since the pandemic.”
It’s possible that adults have historically underestimated the impact of depression and anxiety on adolescents, but there are also more modern pressures from other relatively new factors, such as social media, experts said.
“We continue to improve our understanding and conceptualization of depression and anxiety in children,” Rebecca Kamody, Ph.D., 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 children when we may have missed those symptoms in the past.”
“Current cultural and environmental stressors have significantly influenced the risk of developing depression and anxiety in adolescence, further highlighting the importance of early screening and intervention to prevent escalation in symptom severity,” she added.
Experts say standard screenings — and often the easiest — can be performed in a regular pediatrician’s office, where a familiar face can guide the process and offer possible referrals to other clinicians if needed. Screenings can also be conducted through school-based and community clinics.
“It’s fantastic that we’re 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 does not guarantee that their needs will be addressed.”
“We still have a long way to go before all children have access to affordable, evidence-based mental health care,” she added.