Trending Clinical Topic: Anxiety

Ryan Syrek


September 30, 2022

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With anxiety reportedly on the rise globally, the US Preventive Services Task Force (USPSTF) has posted for public comment new draft recommendations for screening. This, combined with new insights into the pandemic's effect on mental health and promising findings regarding treatment options, resulted in anxiety becoming this week's top trending clinical topic. Perhaps most notably, for the first time, the USPSTF has proposed widespread anxiety screening (see Infographic below).

This recommendation includes pregnant and postpartum women, in addition to any adult aged 19-64 years who does not have a diagnosed mental health disorder or who are not showing clearly visible signs and symptoms of anxiety. For adults aged 65 years or older, evidence on the benefits and potential harms of screening for anxiety were deemed "insufficient." The public comment period for the draft recommendations runs until October 17.

The COVID-19 pandemic elevated mental health concerns around the world. A new report found that major differences were seen across various countries and continents. Researchers screened nearly 400 published articles and conducted meta-analyses on 64 longitudinal studies with 170,000 participants. In particular, the research team looked at the proportions of people who met the diagnostic criteria for anxiety, depression, posttraumatic stress disorder, psychological distress, insomnia, substance abuse, loneliness, and suicidal ideation, comparing the differences between the baseline in 2020 and the last follow-up in 2021.

For anxiety, the pooled prevalence was 25%. North America had a higher prevalence rate, at 43%, compared with 22.1% in Europe, 20.5% in Latin America, and 15% in the Asia-Pacific region. For depression, the pooled prevalence was 26.8%. North America had a higher prevalence rate, at 38.3%, compared with 24.6% in Europe, 20.9% in Latin America, and 20.6% in the Asia-Pacific region. For psychological distress, the pooled prevalence was 30.5%. Latin America had a higher prevalence rate, at 66.6%, compared with 31.2% in North America, 27.4% in Europe, and 18% in the Asia-Pacific region. For insomnia, the pooled prevalence was 22.2%. Europe had a higher prevalence rate, at 30.8%, compared with 21.7% in Asia and 18.8% in North America. For posttraumatic stress disorder, the pooled prevalence was 17.5. Studies in North America reported a prevalence rate of 23.3% compared with 14.4% in studies conducted across Europe. For substance abuse, the pooled prevalence was 24%, with major differences seen among the studies.

Having anxiety may also increase the risk for long COVID, according to new research. In an analysis of almost 55,000 adult participants in three ongoing studies, having psychological distress (anxiety, depression, worry, perceived stress, or loneliness) prior to SARS-CoV-2 infection was associated with increased risk of developing long COVID. Those who had experienced at least two types of distress prior to infection were at nearly 50% increased risk for post-COVID conditions (risk ratio [RR], 1.49; 95% CI, 1.23-1.80). Psychological distress was even more strongly associated with developing long COVID than were physical health risk factors ? and the increased risk was not explained by health behaviors such as smoking or physical comorbidities, according to researchers. Notably, of those studied, 38% were active healthcare workers.

In more encouraging news, several treatment options for anxiety have proven effective, according to recent findings.

  • Results from a retrospective chart review analysis found that ketamine infusions can help reduce symptoms of anxiety, depression, and suicidal ideation among patients with treatment-resistant depression (TRD). The analysis, which included more than 400 participants with TRD, suggests that ketamine is a safe and rapid treatment in a real-world patient population.

  • In regard to nonpharmaceutical interventions, both yoga and cognitive-behavioral therapy were found to provide meaningful improvements in anxiety, worry, and insomnia in older adults. According to a trial of over 500 individuals, these improvements lasted at least 6 months after treatment was discontinued.

  • Earlier this year, research showed that high-dose vitamin B6 supplements may reduce feelings of anxiety and depression. Investigators compared supplementation with a 1-month course of vitamin B6 or B12 vs supplementation with placebo in almost 500 adults. Results of a relatively small study showed that vitamin B6 supplementation was associated with reductions in self-reported anxiety and a trend toward decreased depressive symptoms.

From new screening recommendations to emerging treatment options, the ability to identify and manage anxiety is clearly a priority, given the pandemic's widespread increase in symptoms, and resulted in this week's top trending clinical topic.

Learn more about anxiety disorders.


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