Â鶹´«Ã½

Health

    • Canadian doctors, psychiatrists don't recommend routine adult anxiety screening

    Share

    Contrary to new recommendations by the U.S. Preventive Services Task Force, health-care professionals in Canada are warning against routine anxiety testing for adults.

    The American health guidelines panel released a earlier this week that said U.S. primary care doctors should regularly screen all adults under 65 for anxiety using standardized questionnaires like the generalized anxiety disorder (GAD) scale.

    The panel argues that anxiety disorders are highly prevalent in the U.S. – occurring in 26.4 per cent of men and 40.4 per cent of women – but that they are often unrecognized in primary care settings, leading to years-long delays in treatment. Misdiagnosis rates are higher among Black and Hispanic/Latino patients compared with white patients, the draft recommendation notes.

    “The USPSTF concludes with moderate certainty that screening for anxiety in adults, including pregnant and postpartum persons, has a moderate net benefit,†the document reads. “(There is) adequate evidence that psychological interventions to treat anxiety are associated with a moderate magnitude of benefit for reduced anxiety symptoms in adults, including pregnant and postpartum persons.â€

    However, doctors and psychiatrists with three major mental health research institutions in Canada warn the risks of implementing a routine anxiety screening program here would likely outweigh the benefits.

    Dr. Eddy Lang is a member of the Canadian Task Force on Preventive Health Care and department head for emergency medicine at the University of Calgary’s Cumming School of Medicine.

    Dr. David Gratzer is a medical doctor and attending psychiatrist at the Centre for Addiction and Mental Health.

    Dr. Keith Dobson is a principal investigator for the Mental Health Commission of Canada’s Opening Minds program and faculty professor emeritus in clinical psychology at the University of Calgary.

    All three told CTVNews.ca they have concerns around the evidence supporting the draft recommendation, the outcomes of patients automatically screened for anxiety and how a similar program would be delivered in Canada.

    Here are some of the concerns they shared.

    OVERDIAGNOSIS, MISDIAGNOSIS

    Lang said the Canadian Task Force on Preventive Health Care is aware of the draft recommendations by their U.S. counterparts, but are unconvinced universal screening would actually lead to better outcomes for patients.

    “The evidence cited in these draft recommendations is actually questionable,†he told CTVNews.ca in a phone interview on Thursday. “It shows you can detect more anxiety but it doesn’t show patients will be better off at the end of the day because they are identified or labelled as a person with an anxiety disorder.â€

    Lang said the observational evidence supporting the recommendations only demonstrates that screening leads to a higher rate of diagnosis, but that it doesn’t measure whether patients are less likely to be hospitalized, less likely to miss work, or other indicators of wellbeing. In order to draw those conclusions, he said, the U.S. researchers would have to conduct a randomized study.

    He said the Canadian task force is also concerned standardized screening could lead to overdiagnosis and misdiagnosis.

    “These surveys that are being proposed, they’re far from perfect. They have very high false positive rates, and false negatives, too,†he said. “You could be labelled with a condition that would not ever have harmed you and that you would be better off not knowing about.â€

    Dobson agrees.

    “The range of anxiety problems is large, so screening may identify many people who probably don’t need care,†he told CTVNews.ca in a phone interview on Wednesday. “There are a lot of people who deal with anxiety on a day-to-day basis and don’t need intervention."

    Finally, Lang said false positives can have major implications for patients, especially when doctors prescribe potentially addictive medications like Benzodiazepines, or medications with moderate or severe side effects.

    INADEQUATE RESOURCES

    Lang, Dobson and Gratzer also worry about how a mental health-care system that already struggles to serve patients with obvious anxiety symptoms could accommodate a new influx of anxiety disorder diagnoses.

    “The danger with a screening program like this, potentially, is that you’re adding burden to an already strained system and taking away the opportunity to help those who are in true need,†Lang said.

    “There are already prolonged delays to getting referred to mental health specialists and it’s not going to get better if we start a universal screening program and send more patients, many with false positives, over to psychologists who are already dealing with prolonged wait times and waiting lists for patients who need their help.â€

    Lang said a universal anxiety screening program would also add to the workload of primary care physicians in Canada, many of whom are already overburdened.

    “We know physicians are closing offices, pulling back, leaving for other kinds of work. To now say you have to screen for anxiety in your patients is only going to put more work load onto family physicians,†he said.

    Dobson thinks a routine anxiety screening program could be beneficial in a less-fragmented health-care system than Canada’s. For it to work here, he said the provinces and federal government would need to co-operate to deliver the program consistently across the country.

    “For screening to be done well, it needs to be done nationally, it needs to be available easily, and there needs to be a clear linkage to appropriate services for people who screen positive,†he said.

    “A significant issue may be that national screening might identify people who would benefit from services, but health care is delivered provincially, so finding services might remain a challenge. Also, the standards and mental health services are variable across this country, unfortunately.â€

    Gratzer agrees that the federal and provincial governments need to address these gaps in mental health care before they can take any steps toward creating a mass anxiety screening program.

    “Ultimately, we don’t necessarily need screening. We need better care,†he told CTVNews.ca in a phone interview on Thursday. “If we had really well-funded cognitive behavioural therapy at point-of-use in Canada, the way they do in the United Kingdom, it would be different.â€

    Canada spends approximately nine cents of every health-care dollar on mental health-care funding, Gratzer said, compared to 15 cents of every health-care dollar in the United Kingdom.

    “We need to think about health-care funding and mental health-care funding,†he said.

    “Many people are falling through the cracks in our system. They should get care, they would benefit from care, and yet they can’t get the care they need.†

    CTVNews.ca Top Stories

    An Edmonton man says he was in the wrong place at the wrong time when he was injured by members of the Edmonton Police Service last year.

    Toronto police say they are searching for a suspect who allegedly shot and killed his brother in an argument at a Scarborough housing complex late Saturday night.

    Ontario's police watchdog has decided there are no grounds to believe Sudbury police committed a crime during a difficult arrest in May where the suspect's neck was broken.

    Canada

    • Ontario's police watchdog has decided there are no grounds to believe Sudbury police committed a crime during a difficult arrest in May where the suspect's neck was broken.

    • The City of Calgary ended water restrictions for the city at a Sunday morning update.

    • Toronto police say they are searching for a suspect who allegedly shot and killed his brother in an argument at a Scarborough housing complex late Saturday night.

    • A man is facing numerous drug trafficking charges after Dufferin OPP seized a large assortment of drugs and weapons in Orangeville earlier this week.

    • Pasquale Monaco says he’s debating whether to keep renting out the two-bedroom basement apartment of the Montreal building he owns after it was flooded — again — in August, when the remnants of tropical storm Debby sent four feet of water rushing into the space.

    • Infectious disease physician Dr. Isaac Bogoch says whooping cough is most risky for unvaccinated infants, children and older people.

    World

    Politics

    Health

    Sci-Tech

    Entertainment

    Business

    Lifestyle

    Sports

    • The Winnipeg Blue Bombers have a nickname for the opposition’s end zone. They refer to it as the “chicken box.â€

    • Jonathan Aranda homered for the second consecutive game, helping Taj Bradley and the Tampa Bay Rays beat the Toronto Blue Jays 3-2 on Saturday.

    • Kiefer Sherwood spent several nights last spring chasing Quinn Hughes around the ice and generally pestering the Vancouver Canucks.

    Autos

    Local Spotlight

    Cole Haas is more than just an avid fan of the F.W. Johnson Wildcats football team. He's a fixture on the sidelines, a source of encouragement, and a beloved member of the team.

    Getting a photograph of a rainbow? Common. Getting a photo of a lightning strike? Rare. Getting a photo of both at the same time? Extremely rare, but it happened to a Manitoba photographer this week.

    An anonymous business owner paid off the mortgage for a New Brunswick not-for-profit.

    They say a dog is a man’s best friend. In the case of Darren Cropper, from Bonfield, Ont., his three-year-old Siberian husky and golden retriever mix named Bear literally saved his life.

    A growing group of brides and wedding photographers from across the province say they have been taken for tens of thousands of dollars by a Barrie, Ont. wedding photographer.

    Paleontologists from the Royal B.C. Museum have uncovered "a trove of extraordinary fossils" high in the mountains of northern B.C., the museum announced Thursday.

    The search for a missing ancient 28-year-old chocolate donkey ended with a tragic discovery Wednesday.

    The Royal Canadian Mounted Police is celebrating an important milestone in the organization's history: 50 years since the first women joined the force.

    It's been a whirlwind of joyful events for a northern Ontario couple who just welcomed a baby into their family and won the $70 million Lotto Max jackpot last month.

    • One man is dead and another injured after a shooting in Langley Saturday evening that homicide investigators say is gang-related.

    • Anyone needing emergency care in a city in B.C.’s southern Interior will need to seek help elsewhere until Monday, as the latest ER closure in the region has shuttered the department’s doors for 25 hours.

    • Work crews have been busy in the British Columbia legislature over the summer, prying apart desks in the historic chamber and piling them up in hallways as they tried to work out how to fit in six more seats.

    • Toronto police say they are searching for a suspect who allegedly shot and killed his brother in an argument at a Scarborough housing complex late Saturday night.

    • Roads have reopened near Union Station following a suspicious package investigation on Sunday afternoon.

    • Toronto police have arrested three people and they are looking for two others in connection with an alleged fraud that saw a man and his daughter bilked out of more than $18,000.

    • The City of Calgary ended water restrictions for the city at a Sunday morning update.

    • Nearly 100 Inglewood residents rallied Saturday afternoon in a continuing effort to save the Inglewood Aquatic Centre.

    • Nick Kolomyja reckons axe throwing may have saved his life.

    • A local vendors market with a Taylor Swift theme took place this Sunday in Ottawa.

    • Police are looking to speak with a female who was a passenger in a stolen vehicle that was recovered early Saturday morning in Kanata.

    • Thousands participated in the 17th annual Canada Army Run Sunday in the capital's downtown.

    • Provincial police (SQ) are looking for 29-year-old Kelsey Watt, who went missing in Hemmingford, Que.

    • Nearly 15,000 runners pounded the pavement on Sunday in the 32nd edition of Montreal’s Bereva Marathon.

    • Â鶹´«Ã½ Montreal at Six for Sunday, Sept. 22, 2024 with anchor Matt Gilmour.

    • An Edmonton man says he was in the wrong place at the wrong time when he was injured by members of the Edmonton Police Service last year.

    • The number of Edmontonians experiencing homelessness has risen 47 per cent this year, according to data from the city's main housing agency.

    • One person is dead after an early morning crash in west Edmonton.

    • Saint John Theatre Company’s “Waiting for Godot†stars former "Corner Gas" star Eric Peterson, and R.H. Thomson, known for his role in "Anne with an E."

    • A 76-year-old man who was reported missing Saturday in Annapolis District, N.S., has been found deceased.

    • Manitoba RCMP and community members are still feverishly searching for a six-year-old boy who went missing five days ago.

    • Winnipeg police called in the bomb unit Saturday night after a suspicious item was found in a Centennial neighbourhood back lane.

    • While slang may come and go, experts say the phenomenon behind them, which constantly churns out brand-new bon mots, is as old as language itself.

    • Fire officials are investigating after a fire completely destroyed the community fridge in the Cathedral neighbourhood.

    • The last two months after losing her daughter Bella have been extremely difficult for Kyla Thomson.

    • Regina police arrested three youths in connection to a bear mace incident at a Regina high school on Friday.

    • Brantford, Ont. residents were met with an unexpected sight on Saturday evening as a suspected funnel cloud appeared in the skies above the city.

    • Police were called to a business in the area of University Avenue East and Weber Street North at around 10:40 p.m. Saturday for a report of a man attempting to stab another man.

    • Police said the pedestrian, a 52-year-old man, was taken to an out-of-region hospital with life-threatening injuries and the driver of the vehicle failed to remain at the scene.

    • A 14-year-old girl from Flying Dust First Nation was killed after a high-speed ATV struck a ditch near Meadow Lake.

    • The 75-year-old building, formerly the Waskesiu Chamber of Commerce building, was relocated to the Parks Canada compound on the edge of the townsite.

    • A 53-year-old woman from north Vancouver, B.C. was killed after a semi and truck collided on Highway 16 near Dafoe.

    • There were no injuries reported after a home on Regent Street near Douglas Street in Greater Sudbury’s west end on Sunday morning.

    • Ontario’s police watchdog is investigating after an Ontario Provincial Police officer discharged his firearm at a 36-year-old man in near Moonbeam, Ont., on Friday night.

    • Wage increases, new paid holidays and a big signing bonus are part of the new contract for CAMI employees in Ingersoll, Ont.

    • video

      video

      The most popular hockey podcasters on the planet brought some major attention to the Forest City this weekend with the annual Chiclets Cup.

    • The identity of a motorcyclist has been revealed by loved ones on social media following Friday’s fatal south end collision in London. The London Police Service has not released anything regarding the driver’s identity.

    • One man is in police custody after fabricating a story to police and reporting his vehicle was stolen.

    • Fire crews worked to extinguish a fire at a tent encampment in Barrie on Sunday.

    • A year after being recognized as one of 19 ‘Bee Campuses’ by Bee City Canada, Georgian College continues to promote the importance of bees to agriculture, the economy and education.

    • Essex-Windsor Emergency Medical Services (EMS) is reporting that it’s above the provincial target for sudden cardiac arrest response times.

    • video

      video

      The Amherstburg Uncommon Festival is living up to its name with the addition of a drone light show — a first for Essex County.

    • The St. Clair College Saints were in Oshawa over the weekend as they faced Durham College.

    • Work crews have been busy in the British Columbia legislature over the summer, prying apart desks in the historic chamber and piling them up in hallways as they tried to work out how to fit in six more seats.

    • The leaders of British Columbia's two main political parties are focusing on the challenges facing Metro Vancouver communities as the provincial election campaign enters its second day.

    • A man who was found dead behind a curling rink in Nanaimo, B.C., earlier this month was the victim of a homicide, police confirmed.

    • A pair of runaway pigs are in the custody of an animal sanctuary in the Okanagan after evading police and volunteers for hours earlier this week.

    • The Red Bridge, a historic landmark in Kamloops, B.C., was completely destroyed by fire early Thursday morning.

    • Animal protection officers in British Columbia have rescued three pit bulls – including one that gave birth to 10 puppies – from a rat-infested home in Kelowna.

    • Despite the heavy rain, plenty of muscle turned up for United Way’s annual Pull the Bus fundraiser in Lethbridge Friday.

    • Lethbridge County has rescinded its fire restriction as a result of the recent cool, wet weathr.

    • The Lethbridge Hurricanes kicked off the 2024-25 season on a winning note Friday night, defeating the Edmonton Oil Kings 3-1 in a game played at VisitLethbridge.com Arena.

    • The Royal Canadian Mint has introduced its latest Gold Maple Leaf bullion coin – made entirely from gold sourced from a single mine in northern Ontario

    • A northern Ontario man is facing a $12,000 fine after illegally shooting a moose near the Batchawan River.

    • Following an outbreak of COVID-19 on its continuing care floor and just ahead of the flu season, St. Joseph’s General Hospital in Elliot Lake has opted to re-introduce a universal masking policy until further notice.

    N.L.

    Shopping Trends

    The Shopping Trends team is independent of the journalists at Â鶹´«Ã½. We may earn a commission when you use our links to shop. Read about us.

    Stay Connected
    Follow Â鶹´«Ã½