2/17: Mood and Anxiety disorders Flashcards
anxiety
fear + stress + psych/physio sx
mood
a persistent subjective state
expressed in thought, emotion, behavior, and bodily fx
anxiety disorders
painful/apprehensive uneasiness/fear for anticipated threat accompanied by physiologic signs
major anxiety disorders
panic disorder, social anxiety disorder (social phobia), agoraphobia, generalized anxiety disorder, substance-induced anxiety disorders, anxiety disorder due to another medical condition
panic disorder + definition
recurrent unexpected panic attacks (sudden onset of inc SNS/fear findings), +/- agoraphobia (fear of crowded places in 2+ places) bc cannot escape during another panic attack
panic disorder + onset
recurrent panic attacks occurring >1 m, reach a peak w/in 10 min
panic disorder + epid
women < 30 y/o, inc risk with +FMHx, monozygotic twins, inc comorbidity w/depression + substance abuse
social phobia/anxiety disorder
fear of humiliating performance and exposure to unfamiliar ppl; recognized as excess/unreasonable
- important contrib of dev experiences
- DDx: looks similar to schizoid
simple phobia
tx only if interfere w/important activities (e.g. claustrophobia in MRI, vasovagal (fainting) episodes w/needles)
social phobia tx
Rehearsal (improve competence, Toastmasters), beta-blockers (to reduce stress)
simple phobia tx
short-term tx with short-acting benzos for symptomatic reliefs (fear of flying, claustro in MRI)
repeated gradual exposure (systematic desensitization) to feared stimulus for lasting relief
agoraphobia tx
gradual exposure (systemic desensitization) + SSRIs
Generalized anxiety disorder
inc anxiety or worry about many events + on most days for 6 months, CC somatic sx
Generalized anxiety disorder + diagnostic criteria
3 of the following that produce fx impairment:
-restlessness, irritable, easy fatigue, inc muscle tension, difficulty concentrating, sleep ∆
OCD
inc obsessions or compulsions recognized as excessive/unreasonable and produce functional impairment
substance/med-induced anxiety disorders
pain attacks predominate, 2˚ to med condition
e.g. cocaine, amphetamines, ADHD, caffeine, alcohol, cough syrup
anxiety 2˚ to which general med conditions?
endo (pheochromocytoma, hyperthyroidism, hypoglycemia), metabolic prob, neuro prob (e.g. vestibular dysfx)
mood disorders
unusually intense and persistent mood that occurs out of context and compromised self-care, adaptive fx, and the ability to effectively relate to other ppl
Major depressive disorder sx
Sig-e-caps
Sleep disturbance, Interest/pleasure reduction, Guilt or thoughts of worthlessness, Energy ∆/fatigue, Concentration/attention impairment, Appetite/weight ∆, Psychmotor disturbances, Suicidal thoughts
+ depressed mood
p.373
persistent depressive disorder (aka dysthymia)
low grade chronic “sub threshold” depression (sig-e-caps), persistent and long duration at least 2 yrs (≠intermittent); sx-free period cannot be >2 m.
premenstrual dysphoric disorder
week before onset of menses, feelings of: irritability, anger, food cravings, sleep probs, feeling overwhelmed
sx must have lasted for the better part of a yr, and must be doc PROSPECTIVELY for at least 2 menstrual cycles
sx disappear shortly after onset of menses
cyclothymic disorder
rapidly alternating mood states, occurring >2 yrs, looks like borderline,
note that chaotic life/self-injurious/history of abuse more prominent in borderline
bipolar 1 disorder
classic maniac depression: pt loses contact w/reality, severely impaired judgment
manic sx can be caused by Rx and med condtns (stimulants, hyperthyroid, CNS dz, Cushings) and must be ruled out, requires at least 1 episode of mania
bipolar 2 disorder
distinct period of abn and persistently irritable mood/inc activity or energy, lasting at least 4 consec days, hx of major depression lasted at least 2 wks
do not seek help bc have cycles of “up” episodes
