Anxiety Flashcards
Best pharmacological treatment for BDD
Fluoxetine
The most common comorbidity in OCD
MDD
What kind of learning underlies agoraphobia?
Negative reinforcement
Beta blockers in GAD
Not recommended (CANMAT)
Lifetime prevalence of GAD
6%
GAD first line treatment strategy
CBT
GAD- CBT with pharmacotherapy yes or no?
No according to CANMAT. CBT first, then pharmacotherapy if no response
Co-morbidity rate in GAD
50-90%
Anxiogenic substances
- CCK
- Sodium lactate
- L-Dopa
- Carbon dioxide
- Modafinil
- THC
- LSD
- Amphetamines
- GABA antagonists
- Caffeine
Panic disorder is by definition panic which is unexpected T/F
T
Age of onset in panic disorder
Young adulthood (not adolescence)
Lifetime prevalence of panic disorder
Approx 5%
What percentage of ppl w panic disorder experience nocturnal panic?
40-70%
How many symptoms do you need for the DSM V diagnosis of a panic attack?
Four
CBT has been favoured over pharmacotherapy in a meta-analysis for treatment of panic disorder T/F
T (CANMAT)
Gabapentin is first line in panic disorder T/F
F it’s third line
First line pharmacotherapies in panic disorder CANMAT 2014
- Paroxetine
- Paroxetine CR
- Fluoxetine
- Fluvoxamine
- Venlafaxine XR
- Sertraline
- Escitalopram
- Citalopram
The therapy with the greatest evidence base in trichotillomania
Habit reversal
First line therapies for social anxiety disorder
CBT + exposure therapy alone
Which is the only specific scale for social anxiety disorder?
Liebowitz
Is there an association between panic disorder and mitral valve prolapse?
No- CANMAT 14
Anxiety disorders have a lower age of onset than mood disorders T/F
T (K&S)
A drug with efficacy for trauma related nightmares & poor sleep in PTSD
Prazosin
Antipsychotics may have a role in treatment of flashbacks in PTSD T/F
T
Combat PTSD is harder to treat than civilian PTSD T/F
T
There is an evidence base for EMDR in panic disorder T/F
F
In functional imaging studies in PTSD what happens to a) the amygdala and b) Broca’s area after provocation of symptoms by a stimulus?
A) increased activation of the amygdala B) hypo perfusion of Broca’s
What does yohimbine do to ppl with PTSD and panic disorder but not controls?
Causes anxiety
Smaller hippocampi in PTSD T/F
T
MRI studies in panic disorder have implicated the temporal lobes T/F
T, partic the hippocampus
In PTSD psychological therapy is effective for comorbidity with depression T/F
F, it’s not as effective
Anterior capsulotomy is an option for treatment refractory OCD T/F
T
OCD in kids is associated with what?
Group A strep
Y-BOCS for diagnosis of OCD T/F
F progress of disease
Neuroimaging studies in OCD show hyperactivity in the anterior cingulate T/F
T
Hoarding & symmetry are associated with what kind of response to SSRIs
A poorer one than aggression/religion/sexual subtypes of OCD
Lifetime prevalence of MDD in OCD
67%
Family attitudes predict response to both psychological & pharmacological treatments for OCD T/F
T
Lifetime prevalence of OCD
2-3%
Anxiety disorders have a lower age of onset than mood disorders T/F
T K&S
Anxiety disorders have been consistently shown to be most prevalent in people with poor socioeconomic status and lower levels of education T/F
T (K&S)
Situational panic attacks are more associated with things like social phobia T/F
T because in panic disorder the panic attacks are unexpected
First line adjuncts in OCD (2)
Aripiprazole & risperidone
Lifetime prevalence OCD
1-2.3%
Acute stress reaction, what are the time parameters?
3 days to one month
Caffeine and nicotine can exacerbate symptoms in panic disorder T/F
T
Panic disorder is associated with suicide T/F
T
MRI studies in panic disorder have implicated the temporal lobes T/F
T
Panic and anxiety are associated with cerebral vasodilatation T/F
F constriction
Buspirone is effective in GAD T/F
T
Sjorgren’s syndrome is associated with panic disorder T/F
F, it is associated with GAD though
Abrupt onset of OCD in kids suggests what?
PANDAS paediatric autoimmune neuropsychiatric disorder associated with streptococcus
What role do beta blockers play in the treatment of phobias?
They might be useful in performers eg stage fright
Social phobia can be associated with panic attacks T/F
T
Buspirone is less sedating than benzos T/F
T
Buspirone is useful in panic disorder T/F
F, GAD
What is imaginal exposure?
Pt closes their eyes and imagines a feared stimulus as vividly as possible
What is cynophobia?
Fear of dogs
There needs to be significant weight loss for a diagnosis of avoidant/restrictive food intake disorder T/F
T
PTSD is associated with lower cortisol levels T/F
T
First line Rx pharmacology for PTSD
SSRIs: fluoxetine, paroxetine & sertraline also venlafaxine
Which SSRIs are first line w RCT evidence in PTSD
Sertraline, paroxetine & fluoxetine
Prevalence of obsessions & compulsions in the gen pop
Obsessions 80% Compulsions 55%
Rate of comorbidities in OCD
“Comprbidities are the rule” about 90%
10% of OCD follows a progressive deteriorating course T/F
T
Compulsions for >1 hour/day are in the DSM V criteria for OCD T/F
T
OCD requires higher SSRI doses than ADTs T/F
T
First line meds for OCD
- Paroxetine
- Fluoxetine
- Fluvoxamine
- Sertraline
- Escitalopram
Clomipramine has equal effectiveness to SSRIs but worse tolerability which is why it’s not first line for OCD T/F
T
Chandarana
Clomipramine and fluvoxamine are a possible combo in treatment resistant OCD T/F
T
Group CBT = individual CBT for OCD T/F
T
Chandarana
ECT is useful for treatment resistant OCD T/F
F
Chandarana
Clozapine can make OCD worse T/F
T
How long do panic attacks last?
They peak within minutes according to DSM V
Illness anxiety disorder is not an anxiety disorder T/F
T it’s in somatoform disorders
How many situations do you need to be fearful of for a diagnosis of agoraphobia
Two
Scale for panic disorder
PDSS <7
Specific psychological therapy with demonstrated efficacy for blood injection injury type phobia according to CANMAT 2014
Applied muscle tension (exposure combined with muscle tension exercises)
Specific psychological therapy with demonstrated efficacy for spiders, flying and small animal type phobias according to CANMAT 2014
Computer based self help programs
Specific psychological therapy with demonstrated efficacy for spiders, flying and heights and claustrophobia type phobias according to CANMAT 2014
Virtual reality exposure
Pregabalin is first line for which two anxiety disorders only according to CANMAT 2014?
GAD & SAD
First line GAD CANMAT 2014 (8)
- Venlafaxine XR
- Sertraline
- Escitalopram
- Agomelatine
- Duloxetine
- Pregabalin
- Paroxetine
- Paroxetine XR
(Very Stressed, Edgy And Depressed PPP)