Anxiety

Question 1

GAD anxiety

• describe it
• criteria

Answer 1

• generalised and persistent anxiety “free-floating” -not environmentally associated
• symptoms of anxiety, most days for several weeks
• leads to signif distress/impairment of functioning

NB: +/- transient other sx e.g. low mood but cannot meet full diagnostic criteria for depression/phobic anxiety disorder/panic disorder/OCD…

Question 2

What are the 3 primary sx of anxiety, give an eg of each?

Answer 2

• apprehension e.g. worry of future/misfortunes, feeling on edge, difficulty concentration
• autonomic overactivity e.g. light headed, sweaty, tachyC, epigastric discomfort, dizziness, dry mouth
• motor tension e.g. restless, fidget, tension headache, trembling, inability to relax

Question 3

What is the scoring scale used for generalised anxiety in GP? And in hospital in pts with physical health problems?

Answer 3

GAD-7

-hospital anxiety and depression scale HADS score

Question 4

Suggest 2 Treatments of GAD and suggest duration of medication

Answer 4

• CBT
• SSRI e.g. Sertraline(1st line), Citalopram (QT prolonged risk)
• optimal duration >1yr

Question 5

Define panic disorder

Answer 5

• recurring panic attacks (physical and cognitive sx sudden onset)
• persistent worry of having another
• may avoid situations that trigger attack

Question 6

Define Agoraphobia

Answer 6

• Anxiety and panic sx associated with places/situations where escape may be difficult/embarrassing e.g. crows, public places
• leads to avoidance

Question 7

Define Social Phobia

Answer 7

• Overwhelming anxiety in everyday social situations

- leads to desire for escape/avoidance

Question 8

Define specific/simple phobia

Answer 8

• recurring excessive and unreasonable symptoms of anxiety in presence of specific feared object or situation
• leading to avoidance

Question 9

Panic in A&E how to respond?

Answer 9

• ask if they are receiving rx for a panic disorder
• undergo minimum ix necessary
• avoid admittance to med/psych ward
• psychoeducation + offer written info of sources of support e.g. voluntary and self-help groups
• normalise it
• refer to primary care

Question 10

Name 5 common content of obsessions and compulsions in those who suffer from OCD

Answer 10

• checking
• washing
• contamination/cleaning
• doubting
• bodily fears
• counting
• insistence of symmetry
• aggressive thoughts