19 Anxiety Disorder and OCD Flashcards
What are the symptoms of anxiety?
- Palpitations
- Sweating
- Dizziness
- Chest pain/discomfort
- Difficulty breathing
- Dry mouth
- Nausea/abdominal distress
The limbic system is thought to be responsible for our emotional life and has a role in the creation of memories. What makes up the limbic system?
- Hippocampal formation (hippocampus, dentate gyrus, parts of parahippocampal gyrus)
- Septal area
- Amygdala
(+ prefrontal cortex, anterior cingulate gyrus)
How is the limbic system related to the stress response?
What are the 3 parts making up the hippocampus?
(hippocampus occupies floor of temporal horn of lateral ventricle)
Three parts of hippocampus:
- Subiculum
- Hippocampus proper
- Dentate gyrus
The amygdala has a role in driving related behaviours and processing of associated emotions.
Where is it found?
What is it made up of?
How does it carry out it’s function?
Where is it found?
In roof of lateral ventricle
What is it made up of?
Collection of nuclei
How does it carry out it’s function?
- Inputs of sensory information, brainstem, thalamus, cortex*
- Outputs to cortex, brainstem and hypothalamus*
Useful diagram showing inputs and outputs of hypothalamus
Outline the fight or flight response with reference to the sympathetic nervous system and the pituitary gland.
Anxiety disorders are the result of a treat to ability to cope imbalance. Give some examples of anxiety disorders (4)
What neurotransmitter levels are decreased in the cortex of patients with panic disorder (anxiety)?
GABA (main inhibitory neurotransmitter)
How do benzodiazepines work to reduce anxiety?
Benzodiazepines- increase GABA transmission- reduce anxiety
How do SSRIs work to reduce anxiety? (selective serotonin reuptake inhibitors)
Increases levels of serotonin: neuroprotection, neurogenesis and reduce anxiety
How do we treat anxiety disorder? Why should we not use benzodiazepines long term?
- CBT
- SSRIs
- Pregabalin (GABA analogue)
-
Benzodiazepines (short term)
- BAD WITHDRAWAL SYMPTOMS
GABA= main inhibitory neurotransmitter
What is an obsession?
Not just a preoccupation
Thought - persists an dominates an individuals thinking
Beyond point of relevance or usefulness
Despite person’s awareness the thought is without purpose
What are compulsions?
Obsessive motor acts
What is the diagnostic criteria for OCD? (4)
When does a person usually start to show signs of OCD?
Adolescence/early adulthood
(childhood OCD more common in boys)
Explain the theory of the re-entry circuit in the basal ganglia as an explanation for OCD.
What is PANDAS? How is it treated?
Paediatric Autoimmune Neuropsychiatric Disorder associated with Streptococcal Infection
- Sudden onset OCD or tics
- –> after Group A beta haemolytic strep infection
- Age 3-12 yrs
- Anitbodies ‘cross- react’ with neurons in basal ganglia
Treatment
- Antibiotics
- OCD management (usual)
How is OCD treated?
- CBT
- Exposure response prevention
- SSRIs (need higher dose and longer than in depression)
- Antipsychotics
- Deep brain stimulation- electrical impulses sent to brain from implant
What is PTSD? (ie what is our diagnostic criteria)
Within 6 months of traumatic event of exceptional severity
Evidence of trauma
= repetitive, intrusive recollection or re-enactment of event in memories/dreams/daytime imagery
Like being back in moment- may actviate sensory and motor response
–> visible emotional detachment, numbing of feeling, avoidance of stimuli that might trigger recollection of trauma
What is the pathophysiology of PTSD thought to be?
How is PTSD treated?
- CBT
- Eye movement desensitisation and reprocessing (EMDR)
- Facilitate processing of memory-hold memory-follow fingers
- Medical treatment: same as anxiety disorders
