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Most Adults Should Be Screened For Anxiety, Depression According To US-Funded Panel

Most Adults Should Be Screened For Anxiety, Depression According To US-Funded Panel

A panel of experts operating under the Department of Health…

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Most Adults Should Be Screened For Anxiety, Depression According To US-Funded Panel

A panel of experts operating under the Department of Health and Human Services has recommended that all adults under the age of 65 should be screened for anxiety disorders, and all adults regardless of age should be checked for depression amid an uptick in American reporting mental-health issues following the Covid-19 pandemic.

The guidance, released Tuesday, marks the first such recommendation regarding adult anxiety disorders from the US Preventative Services Task Force, which issued similar draft guidance several months ago for children and adolescents, the Wall Street Journal reports.

"This is a really important step forward," said American Psychological Association CEO Arthur C. Evans. "Screening for mental-health conditions is critical to our ability to help people at the earliest possible moment."

The task force said that there wasn’t enough evidence on whether or not screening all adults without signs or symptoms ultimately helps prevent suicide. The group didn’t recommend for or against screening for suicide risk, but called for more research in the area.

The task force, a panel of 16 independent volunteer experts, issues guidance on preventive-care measures. Health insurers are often required to cover services recommended by the task force under a provision in the Affordable Care Act. -WSJ

According to estimates from the federal Household Pulse Survey, over 30% of adults reported having symptoms of anxiety disorder or depressive disorder this summer, while the CDC reports that the percentage of US adults who received mental-health treatment over the past year increased from 19% in 2019 to 22% in 2021.

Mental health issues are often caught during doctor's office screenings, where patients fill out questionnaires that can identify at-risk individuals who may not be showing obvious signs of a problem. The surveys ask about feelings of depression or hopelessness, trouble sleeping, eating, or thoughts of harming themselves, on a scale of 'not at all' to 'nearly every day.'

"It helps me get a better idea about whether their insomnia is really pure insomnia or if it is part of depressive symptoms," Dr. Riza Conroy, a primary-care physician at Ohio State University, told the Journal.

That said, widespread screening can also yield false-positives, leading to potential overdiagnosis and unnecessary treatment that may instead cause side effects, along with 'unease and stigma,' according to the task force and other mental-health experts.

"You could be flagging a lot of older adults for having an anxiety disorder when they don’t," said Dr. Lori Pbert, task-force member and professor in the department of population and quantitative health sciences at UMass Chan Medical School.

"You end up with a score that you feel you have to act on," said Stephanie Collier, a psychiatrist at McLean Hospital and a consulting psychiatrist for the Population Health Management Team at Newton-Wellesley Hospital in Massachusetts, who wasn’t involved with the new guidance.

To inform the new recommendations, task-force members reviewed evidence from some 173 studies that looked at screening-test accuracy and the effectiveness of available interventions for depression, anxiety disorders and suicide risk. A few studies looked at the direct impacts of the screening itself on health outcomes.

The task force concluded that screening all adults for depression, including those who are pregnant or postpartum as well as older adults, has a moderate net benefit, echoing its previous 2016 recommendations. The task force also recommended screening adults under 65, including pregnant and postpartum people, for anxiety but said that there wasn’t enough evidence to make the same recommendation for older adults. -WSJ

According to the report, the Task Force received some pushback in April over its lack of recommendation for suicide screening among adolescents.

"It could present a threat to forward progress in preventing suicide at a time when it’s clearly showing up as a national health crisis," said Christine Yu Moutier, chief medical officer at the American Foundation for Suicide Prevention.

According to task force member Gbenga Ogedegbe, healthcare providers should use their professional judgement for each patient to determine whether to screen for suicide risks.

Tyler Durden Wed, 09/21/2022 - 18:40

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International

I’m headed to London soon for #EUBIO22. Care to join me?

Adrian Rawcliffe
It was great getting back to a live ESMO conference/webinar in Paris followed by a live pop-up event for the Endpoints 11 in Boston. We’re…

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Adrian Rawcliffe

It was great getting back to a live ESMO conference/webinar in Paris followed by a live pop-up event for the Endpoints 11 in Boston. We’re staying on the road in October with our return for a live/streaming EUBIO22 in London.

Kate Bingham

Silicon Valley Bank’s Nooman Haque and I are once again jumping back into the thick of it with a slate of virtual and live events on October 12. I’ll get the ball rolling with a virtual fireside chat with Novo Nordisk R&D chief Marcus Schindler, covering their pipeline plans and BD work.

After that I’ve teed up two webinars on mRNA research — with some of the top experts in Europe — and the oncology scene, building better CARs in Europe.

That afternoon, we’ll switch to a live/streaming hybrid event, with a chance to gather once again now that the pandemic has faded. I’ve recruited a panel of top biotech execs to look at surviving the crazy public market, with Adrian Rawcliffe, the CEO of Adaptimmune, SV’s Kate Bingham, Mereo CEO Denise Scots-Knight and Andrew Hopkins, chief of Exscientia.

Andrew Hopkins
Denise Scots-Knight

That will be followed by my special, live fireside chat with Susan Galbraith, the oncology R&D chief at AstraZeneca. And then we’ll turn to Nooman’s panel, where he’ll be talking with Katya Smirnyagina with Oxford Science Enterprises, Maina Bhaman with Sofinnova Partners and Rosetta Capital’s Jonathan Hepple about navigating the severe capital headwinds.

You can review the full schedule and buy tickets here and review everything we have planned. It will be a packed day. I hope to see you there. It’s been several years now since I’ve had a chance to meet people in the Golden Triangle. I’m very much looking forward to it.

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We can turn to popular culture for lessons about how to live with COVID-19 as endemic

As COVID-19 transitions from a pandemic to an endemic, apocalyptic science-fiction and zombie movies contain examples of how to adjust to the new norm…

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An endemic means that COVID-19 is still around, but it no longer disrupts everyday life. (Shutterstock)

In 2021, conversations began on whether the COVID-19 pandemic will, or even can, end. As a literary and cultural theorist, I started looking for shifts in stories about pandemics and contagion. It turns out that several stories also question how and when a pandemic becomes endemic.


Read more: COVID will likely shift from pandemic to endemic — but what does that mean?


The 2020 film Peninsula, a sequel to the Korean zombie film, Train to Busan, ends with a group of survivors rescued and transported to a zombie-free Hong Kong. In it, Jooni (played by Re Lee) spent her formative years living through the zombie epidemic. When she is rescued, she responds to being informed that she’s “going to a better place” by admitting that “this place wasn’t bad either.”

Jooni’s response points toward the shift in contagion narratives that has emerged since the spread of COVID-19. This shift marks a rejection of the push-for-survival narratives in favour of something more indicative of an endemic.

Found within

Contagion follows a general cycle: outbreak, epidemic, pandemic and endemic. The determinants of each stage rely upon the rate of spread within a specified geographic region.

Etymologically, the word “endemic” has its origins with the Greek words én and dēmos, meaning “in the people.” Thus, it refers to something that is regularly found within a population.

Infectious disease physician Stephen Parodi asserts that an endemic just means that a disease, while still prevalent within a population, no longer disrupts our daily lives.

Similarly, genomics and viral evolution researcher Aris Katzourakis argues that endemics occur when infection rates are static — neither rising nor falling. Because this stasis occurs differently with each situation, there is no set threshold at which a pandemic becomes endemic.

Not all diseases reach endemic status. And, if endemic status is reached, it does not mean the virus is gone, but rather that things have become “normal.”

Survival narratives

We’re most likely familiar with contagion narratives. After all, Steven Soderbergh’s 2011 film Contagion, was the most watched film on Canadian Netflix in March 2020. Conveniently, this was when most Canadian provinces went into lockdown during the early stages of the COVID-19 pandemic.

A clip from the film Contagion showing the disease spreading throughout the world.

In survival-based contagion narratives, characters often discuss methods for survival and generally refer to themselves as survivors. Contagion chronicles the transmission of a deadly virus that is brought from Hong Kong to the United States. In response, the U.S. Centers for Disease Control is tasked with tracing its origins and finding a cure. The film follows Mitch Emhoff (Matt Damon), who is immune, as he tries to keep his daughter safe in a crumbling Minneapolis.

Ultimately, a vaccine is successfully synthesized, but only after millions have succumbed to the virus.

Like many science fiction and horror films that envision some sort of apocalyptic end, Contagion focuses on the basic requirements for survival: shelter, food, water and medicine.

However, it also deals with the breakdown of government systems and the violence that accompanies it.

A “new” normal

In contrast, contagion narratives that have turned endemic take place many years after the initial outbreak. In these stories, the infected population is regularly present, but the remaining uninfected population isn’t regularly infected.

A spin-off to the zombie series The Walking Dead takes place a decade after the initial outbreak. In the two seasons of The Walking Dead: World Beyond (2020-2021) four young protagonists — Hope (Alexa Mansour), Iris (Aliyah Royale), Silas (Hal Cumpston) and Elton (Nicolas Cantu) — represent the first generation to come of age within the zombie-infested world.

The four youth spent their formative years in an infected world — similar to Jooni in Peninsula. For these characters, zombies are part of their daily lives, and their constant presence is normalized.

The trailer for the second season of AMC’s The Walking Dead: World Beyond.

The setting in World Beyond has electricity, helicopters and modern medicine. Characters in endemic narratives have regular access to shelter, food, water and medicine, so they don’t need to resort to violence over limited resources. And notably, they also don’t often refer to themselves as survivors.

Endemic narratives acknowledge that existing within an infected space alongside a virus is not necessarily a bad thing, and that not all inhabitants within infected spaces desire to leave. It is rare in endemic narratives for a character to become infected.

Instead of going out on zombie-killing expeditions in the manner that occurs frequently in the other Walking Dead stories, the characters in World Beyond generally leave the zombies alone. They mark the zombies with different colours of spray-paint to chronicle what they call “migration patterns.”

The zombies have therefore just become another species for the characters to live alongside — something more endemic.

The Walking Dead, Fear the Walking Dead (2015-), Z Nation (2014-18), and many other survival-based stories seem to return to the past. In contrast, endemic narratives maintain a present and sometimes even future-looking approach.

Learning from stories

According to film producer and media professor Mick Broderick, survival stories maintain a status quo. They seek a “nostalgically yearned-for less-complex existence.” It provides solace to imagine an earlier, simpler time when living through a pandemic.

However, the shift from survival to endemic in contagion narratives provides us with many important possibilities. The one I think is quite relevant right now is that it presents us with a way of living with contagion. After all, watching these characters survive a pandemic helps us imagine that we can too.

Krista Collier-Jarvis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Xi Reemerges In 1st Public Appearance After ‘Coup’ Rumors

Xi Reemerges In 1st Public Appearance After ‘Coup’ Rumors

So much for the "coup in China" and "Xi is missing" rumor mill of the past week,…

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Xi Reemerges In 1st Public Appearance After 'Coup' Rumors

So much for the "coup in China" and "Xi is missing" rumor mill of the past week, which at one point saw Chinese President Xi Jinping's name trending high on Twitter...

"Chinese President Xi Jinping visited an exhibition in Beijing on Tuesday, according to state television, in his first public appearance since returning to China from an official trip to Central Asia in mid-September – dispelling unverified rumours that he was under house arrest."

He had arrived in Samarkand, Uzbekistan on September 15 - and attended the days-long Shanghai Cooperation Organization (SCO) summit - where he met with Russian President Vladimir Putin, among others.

Xi is "back"...image via state media screenshot

Importantly, it had been his first foreign trip in two years. Xi had not traveled outside of the country since before the Covid-19 pandemic began.

But upon returning the Beijing, he hadn't been seen in the public eye since that mid-September trip, fueling speculation and rumors in the West and on social media. Some pundits floated the idea that he had been under "house arrest" amid political instability and a possible coup attempt.

According to a Tuesday Bloomberg description of the Chinese leader's "re-emergence" in the public eye, which has effectively ended the bizarre rumors

Xi, wearing a mask, visited an exhibition in Beijing on Tuesday about China's achievements over the past decade, state-run news outlet Xinhua reported. The Chinese leader was accompanied by the other six members of the Politburo Standing Committee, a sign of unity after rumors circulated on Twitter about a challenge to his power.

He'll likely cinch his third five-year term as leader at the major Chinese Communist party’s (CCP) meeting on October 16. The CCP meeting comes only once every half-decade.

What had added to prior rumors was the fact that the 69-year old Xi recently undertook a purge of key senior security officials. This included arrests on corruption charges of the former police chiefs of Shanghai, Chongqing and Shanxi.

More importantly, former vice minister of public security Sun Lijun and former justice minister Fu Zhenghua were also sacked and faced severe charges.

Concerning Sun Lijun, state media made this shocking announcement a week ago: "Sun Lijun, former Chinese vice minister of public security, was sentenced to death with a two-year reprieve for taking more than 646 million yuan of bribes, manipulating the stock market, and illegally possessing firearms, according to the Intermediate People's Court of Changchun in Northeast China's Jilin Province on Friday." The suspended death sentence means he'll spend life in prison.

Tyler Durden Wed, 09/28/2022 - 14:05

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