Preventive Services Task Force

The APTA Practice Committee would like to share updates on The United States Preventive Services Task Force which has just released a final recommendation that primary care clinicians screen all adult patients under 65 for anxiety. The APTA recommendations complement guidance by the task force that were adopted in 2022.

In your role as primary care clinicians, with scope that encompasses screening for mental and behavioral conditions, physical therapists and physical therapist assistants should be prepared to take part in patient screenings for anxiety.

According to the Centers for Disease Control and Prevention, 41.5% of adults reported recent symptoms of an anxiety or depressive disorder in 2021, and in 2020 18.4% of adults reported having been diagnosed with depression sometime in their lives. USPSTF has reported that lifetime prevalence of anxiety is 26% for men and 40% for women. Among children and adolescents, research by the Health Resources and Services Administration indicated that in 2020, 5.6 million children (9.2%) had been diagnosed with anxiety disorders.

Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread, which can interfere with daily life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years.

Symptoms of GAD include:

• Feeling restless, wound-up, or on-edge
• Being easily fatigued
• Having difficulty concentrating
• Being irritable
• Having headaches, muscle aches, stomachaches, or unexplained pains
• Difficulty controlling feelings of worry
• Having sleep problems, such as difficulty falling or staying asleep

Risk factors for anxiety disorders include sociodemographic factors, psychosocial factors, and physical and mental health factors such as marital status (widowed or divorced), stressful life events, smoking and alcohol use, other mental health conditions, or a parental history of mental disorders. Demographic factors such as low socioeconomic status and female sex are associated with higher rates of anxiety disorders. Black persons and individuals of non-Hispanic ethnicity are at increased risk of anxiety disorders due to social, rather than biological, factors. Anxiety and depressive disorders often overlap. One cohort study found that 67% of individuals with a depressive disorder also had a current anxiety disorder, and 75% had a lifetime comorbid anxiety disorder.

The APTA Practice Advisory gives guidance to the PT and PTA’s on how to take part in screening.

• What you need to know.
• Who it impacts.
• Signs and Symptoms.
• Screening tools.
• References for additional guidance.

As primary care givers and those who are offered much trust by your clients this guidance is helpful to ensure that you further support their needs. 

Practice Advisory | Screening Patients for Anxiety | APTA

Karleen Cordeau PT, MS Practice Committee Chair