3.2 - Anxiety disorders

Question 1

What is an anxiety disorder ?

Answer 1

When anxiety, which is a normal reaction, becomes excessive and disabling

Question 2

How can anxiety disorders be qualified ?

Answer 2

• Among the most common psychiatric disorders
• High rate of comorbidity with othe disorders
• result in significant disability and decreased quality of life

Question 3

According to the DSM-4, what are the disorders in the class of anxiety disorders ?

Answer 3

• Panic disorder
• Social Phobia
• Obsessive Compulsive Disorder (OCD)
• Specific phobia
• Generalized anxiety disorder
• Post-traumatic Stress disorder (PTSD)

Question 4

What is a panic attack ?

Answer 4

Sudden attack of terror with somatic manifestations (rapid heartbeat, sweating, weakness, dizziness, fear of losing control, of dying).

Sense of unreality, lose control of their breathing, fear of dying from lack of air

Short duration, with symptoms peaking within the first ten minutes

Question 5

What is a panic disorder ?

Answer 5

Repeated panic attacks.

It is common for people with a panic disorder to experience other serious difficulties (depresion, other anxiety disorders such as social phobia, GAD)

Question 6

What are the consequences of panic disorder ?

Answer 6

Individuals adapt their lives to avoid experiencing high levels of anxiety.

People do not generally consult when attackes occur because :

• worried about the stigma
• attribute the attack to something else, possibly another major physical or mental disorder

In an attempt to cope with fear and anxiety, drug or alcohol abuse is common, making the earliest possible treatment a priority.

Question 7

What is social phobia ?

Answer 7

Being excessively self-conscious, with a fear of social rejection when observed and judged by others.

Embarrassed by :
- situations where their performance is evaluated (exams, sport competitions)

Question 8

What are the manifestations of social phobia ?

Answer 8

Activation of the autonomic nervous system, physiological processes associated with the fight/flight response (sweating, increased pulse, shaking…)

People cognitively interpret their professional and personal experiences as distressing and difficult.

Can cause panic attacks.

Question 9

What is Obsessive Compulsive Disorders ?

Answer 9

• Intrusion of recurring thougths (obsession)
• which lead to repetitive, unnecessary actions (compulsions) that often become rituals, to regulate the anxiety produced by the thoughts

E.g. obsessed with germs, cleaning or grooming compulsions (repeated showers, or hand washing)

Question 10

What is a specific phobia ?

Answer 10

Acute fear of an object.

People may live a functional life

Question 11

How many percentage of the population is affected by a specific phobia ?

Answer 11

6-7%

Question 12

What is the Generalized Anxiety Disorder ?

Answer 12

Expanded state of anxiety that impacts a person’s life totally

Question 13

What are the main feature of the GAD ?

Answer 13

• excessive worry
• tendency to anticipate a lot of things
• tendency to see verything from a defeatist point of view

Question 14

What is the Post-Traumatic Stress Disorder ?

Answer 14

Disorder caused by a s astressful situation

People relive the trauma in their thoughts, day and night, during flashbacks consisting of powerful emotions, images, etc
Feel very anxious for some months, or years after the event.

Question 15

How is anxiety generally treated ?

Answer 15

Using both medication and psychotherapy

Question 16

What medication is ued to treat anxiety disorder ?

Answer 16

• Anti-depressants (SSRIs : serotonine reuptake inhibitors, tricyclics, MAOIs : monoamine oxidase inhibitors
• Anti-anxiety drugs (benzodiazepines, azapirone, benzoxazine…)
• beta-blockers (propanolol, …)

Question 17

What type os psychotherapy is used ?

Answer 17

Cognitive-behavioral therapy
People are encouraged to cope with their anxiety-provoking thoughts by modifying their attitudes or thoughts.

Psychoanaysis can be prescribed to understand the reasons underlying anxiety.

Question 18

What are the main specific phobia (12+2) ?

Answer 18

• Insects (acaro-, entomo-, insecto-), mice (muso-, muro-, suri-), snakes (ophidio-, snake-)
• height (acro-, alto-, bato-, hypsi-, hyposo-)
• public transport (agora-)
• water (hydro-)
• storm, thunder (bronto-)
• crowded places (agora-)
• enclosed spaces (claustro-)
• tunnels, bridges (gephyro-, agora-)
• talk in front of a familiar audience (agora-)
• to go out alone (agora-)
• to stay alone, isolated (auto-, mono-, isolo-)
• to keep at a safe distance from dangerous animals
  +
• to talk with strangers (social)
• to eat with familiar persons (social)