Anxiety Flashcards
Types of anxiety
Generalised anxiety disorder.
Phobias.
Panic disorder.
Obsessive-Compulsive disorder
Associated factors with anxiety
Lower social class, unemployment, divorced, no educational quals, urban living, FHx, childhood adversity
Psychological symptoms of anxiety
Fears, worries, poor concentration, irritability, depersonalisation, derealisation, insomnia, night terrors
Motor symptoms of anxiety
Restlessness, fidgeting, feeling on edge
Neuromuscular symptoms
Tremor, tension headache, muscle ache, dizziness, tinnitus
GI symptoms
Dry mouth, can’t swallow, nausea, indigestion, butterflies, flatulence, frequent or loose motions.
Urinary frequency, erectile dysfunction, amenorrhoea
CVS and resp symptoms
Chest discomfort and palpitations, difficulty inhaling and tight chest
Features of GAD
Generalised and persistent free floating anxiety symptoms. Apprehension, motor tension, autonomic overactivity
Symptoms of autonomic overactivity
Light-headedness, sweating, tachycardia, epigastric discomfort, dizziness
Symptoms of motor tension
Restlessness, fidgeting, tension headaches, trembling, inability to relax
Symptoms of apprehension
Worries about future misfortune, feeling on edge, difficulty concentrating
Differential diagnoses
Hyperthyroidism, substance misuse, excess caffeine, depression, avoidant personality disorder, dementia and schizophrenia early
General management of GAD
Counselling, self help materials, CBT, anxiety management, relaxation techniques, autogenic techniques, brief focal therapy
First line drug therapy in GAD
SSRI or SNRI
When are beta blockers useful
Effective in patients with somatic anxiety symptoms
Features of panic disorder
Recurrent attacls of severe anxiety not restricted to any particular situation or set of circumstances and therefore unpredictable. Secondary fears of dying, losing control or going mad
Characteristic attacks in panic disorder
Attacks usually last for minutes, often there is a cresendo of fear and autonomic symptoms. Freedom from anxiety between attacks
Which gender is anxiety more common in
Females
Age of anxiety starting
Very rarely presents above 30,and if it does it is likely due to depressive disorder or organic disease
What can panic disorder lead to
Can lead to fear of situation where panic attacks occur or agoraphobia, a conditioned fear of fear pattern develops
Differentials of GAD
GAD, agoraphobia, depression, alcohol or drug wthdrawal, organic causes (CVS, resp, hypoglycaemia, hyperthyroidism)
Psychological management of panic disorder
Reassurance, CBT effective >80% and first line.
Education, cognitive restructuring.
Interoceptive exposure techniques.
Secondary agoraphobic avoidance
Drug management of panic disorder
SSRIs are first line but second line to CBT.
Clomipramine
