Anxieties And Phobias

Question 1

How would you describe panic disorder

Answer 1

It is recurring, unforeseen panic attacks
At least two required for diagnosis
It is not associated with particular triggers
Panic attacks are sudden onset episodes which may include:
Palpitations, chest pain, choking sensation, dizziness, abrupt start, derealisation, depersonalisation

Question 2

When people have panic disorder “, is there a particular trigger for this

Answer 2

There is no particular trigger

Question 3

What is the management of a patient with panic disorder?

Answer 3

Acutely, you would concentrate on breathing and reassure the patient

Chronic:
– mild to moderate: low intensity self-help

– moderate to severe: CBT is fast line

– however if CBT is unsuitable/declined/ineffective, can prescribe antidepressants

– SSRI : sertaline, escitalopram, paroxetine

Question 4

What is agoraphobia

Answer 4

People with agoraphobia have a fear of public spaces, crowds, being away from home, using public transport, being in trapped areas

Question 5

What is the cause of agoraphobia?

Answer 5

One third of people with panic disorder develop agoraphobia.
They worry about the places that they have had a panic attack them before and therefore symptoms of anxiety develop in those spaces, this leads to them having agoraphobia.
Other causes might include a fear of terrorism, infections, violence
Some believe that they have psychological causes such as stress, traumatic childhood, fear and increased neurotransmitter release

Question 6

What is the management for agoraphobia?

Answer 6

Self-help, such as deep breathing and focusing on positive visualisation
– guided self-help
– CBT
– exposure therapy (systematic desensitisation)
– If necessary, SSRI (sertraline)

Question 7

Describe social phobias, what are they

Answer 7

Social phobia is the fear or anxiety of being judged socially. This may include meeting new people, public speaking, being seen in public in general.
The patient may feel sick, tremble, blush, have palpitations, sweat

Question 8

When do you patients with agoraphobia first start noticing symptoms

Answer 8

20 to 35

Question 9

When do you patients with social phobia first start noticing symptoms?

Answer 9

13

Question 10

Describe some causes of social phobias

Answer 10

Low self-esteem, past triggers

Question 11

Go through the management of a patient with a social phobia

Answer 11

CBT is fast line
If necessary SSRIs can be used for example sertraline or escitalopram

Note only CBT should be offered in children

Question 12

At what age do you specific phobias first begin?

Answer 12

Childhood