Anxiety Flashcards
Clinical features of anxiety
1) thoughts of being apprehensive, nervous or frightened
2) the physical reaction and awareness of it
- > physical arousal
- worrying thoughts
- irritability
- poor concentration
- fearful anticipation
- >sleep disturbance
- > muscle tension
- > hyperventilation
- dizziness
- tingling
- > autonomic arousal
- dry mouth
- diarrhoea
- palpitations
Panic attack
Sudden crescendo of severe anxiety
Associated with intense awareness of physiological
Feelings of unreality are common
Associated with catastrophic conditions
Specific phobias
Clearly specific and discernible objects/situations Clear avoidance of stimuli 1) situational 2) natural environment 3) blood/injection/injury 4) animals 7% prevelance Usually onset in early life Chronic
Social phobia
Fear of social situations that may involve scrutiny by others that may cause humiliation May only be in specific situations 4.5% prevelance Insidious onset over adolescence *often leads to substance abuse Comfortable alone Present when they run in to difficulties CBT
Agoraphobia
Fear of entering crowded spaces/open spaces/confined spaces
-> where immediate escape is difficult
3% prevelance
Sudden onset in early adulthood
Women of childbearing age
Uncomfortable on their own
Commonly a secondary complication of panic disorder
Panic disorder
Recurrent, unpredictable attacks, not restricted to specific situations Fear of further attacks Symptom free between attacks 1-2% prevelance Usually sudden onset M:F 1:4 High intensity service users
Generalised anxiety disorder
Long standing, free floating anxiety Excessive worry and apprehension on most days for about 6 months Difficulties controlling worry 1) apprehension 2) motor tension 3) autonomic overactivity 4% prevelance M:F 1:2
Obsessions
Involuntary thoughts, images or impulses
Recurrent and intrusive
Enter the mind against conscious resistance
Recognised as the patient as from their own mind
Compulsions
Repetitive mental operations or physical acts
Patients feel compressed to perform them in response to their obsessions
Performed to reduce anxiety in the belief that they will prevent a dreaded event
OCD ICD-10 criteria
Present for at least 2 successive weeks and a source of distress
At least one compulsion is resisted unsuccessfully
Compulsion is not pleasurable
Unpleasantly repetitive
OCD epidemiology
Common and normal in childhood
M=F
Symptoms frequently co exist with other psych conditions
PTSD
1-6 months after traumatic event Repetitive re experiencing of event -flash backs -distress at internal or external question that resemble stressor -hallucinations -illusions Avoidance of stimuli Increase arousal
Medical conditions associated with anxiety
Those that cause:
Dysopnea
Increased sympathetic outflow
Pain
Cushings Hyperthyroidism Intoxication *caffeine Vit deficiencies Withdrawal
Drugs that may cause anxiety
Antidepressants Corticosteroids Sympathomimetics Thyroid hormones Caffeine Anticholinergics Antipsychotics
Aetiology of anxiety
Moderate genetic contribution, particularly panic and OCD
Linked to stressful life events
Consequence of inappropriate thought process
Eg misinterpretation of normal bodily stimulus
