Anxiety Flashcards
What is anxiety
It is a part of the fight or flight, but when it begins to interfere with daily activity or becomescontrollable it is known as anxiety/the feeling of stress or uncontrol
What are the statistics for anxiety? Female to male ratio?
The lifetime prevalence of generalised anxiety disorder is 5%
The lifetime risk is 25%
current prevalence of 3%
The male to female ratio is 2 to 1
What are the risk factors for anxiety
Unemployment
substance abuse including drugs and alcohol
Overload in work or studies
Single Parent/living alone
Domestic abuse or child abuse
Five times increase in risk if first-degree relative
Illness chronic
Is the ICD diagnostic criteria
Excessive worry UnAble to control this worry Three of the following: Restlessness Fatigue Difficulty concentrating Irritability Disturbance to sleep Muscle tension
Other symptoms include
Palpitations Tachycardia Trembling Sweating DRY MOUTH Dysponea Feeling of choking Chest pain Ibs like symptoms Hair loss Nausea Dizziness
Fear of dying
Derealisation of objects or self
Hot flushes cold chills
Tingling sensation
Differentials include
Panic Disorder PTSD OCD Phobias including social dementia depression schizophrenia alcoholism Stress
Investigations
history taking including social history
anxiety scale Hamilton
health questionnaires
becks anxiety inventory
Want to exclude organic causes such as anaemia and Hyperthyroidism and so bloods
What are the treatment options
First line is to remove the cause Drug and alcohol clinics Exercise and lifestyle management through "mindfulness" CBT and talking therapies Support groups Finding ways to cope
Medication options
My first one is SSR1 - citrloram sertaline
Others include
SNRI - venlafaxine duxloxetine
TCA
Mirtzapine
Pregabalin
Benzodiazepines
is a key consideration of which group of medication
Benzodiazepines, risk of dependency therefore no longer than four weeks of use should be given for acute episodes
