Anxiety Flashcards
anxiety disorders are a malfunction in the ____ and ____ of stress
anxiety disorders are a malfunction in the context and extent of stress
give examples of dissociative symtpoms
derealisation, depersonalisation
what is derealisation
feeling like you’re disconnected from world around you
what is depersonalisation?
feeling distant from self “I’m not really here”, “my body doesn’t belong to me”
what conditions are derealisation and depersonalisation associated with?
SZ, PTSD, BPD, bipolar, anxiety disorders
what is meta-worry
worry about worrying
in a PTx over 40 years presenting with anxiety type symptoms, suspect _____ or ____ as more likely
depression or thyroid disorder
what age and gender are generalised anxiety disorder more common in?
20-40yr F>M
generalised anxiety disorder is irrational and present in specific situations. T or F
false
generalised anxiety disorder is irrational and present in any circumstance
how long must anxiety be present for a diagnosis of generalised anxiety disorder?
most days for 6 months
what distinguishes generalised anxiety disorder from everyday anxiety?
impairs function
what is the 1st line Mx of generalised anxiety disorder?
self help
what is the 2nd line Mx or 1st line if longstanding of generalised anxiety disorder?
options:
CBT
SSRI (escitalopram, paroxetine)
2wk benzo
in the management of generalised anxiety disorder, if a SSRI is unsuccessful, what drug class should be tried next?
SNRI
in what age range does panic disorder occur
15-40
what trigger panic attacks in panic disorder?
unpredictable
during a panic attack, metabolism in what area of the brain is increased
temporal
are panic attacks due to depression?
no
during a panic attack, patients often feel like they “are going to _____”
“i am going to die”
what is the 1st line management of mild panic disorder
self help
what is the 1st line management of longstanding panic disorder / the 2nd line management of mild panic disorder?
CBT or SSRI
what drug class should be avoided in panic disorder?
benzos
what is the 3rd line mx of panic disorder, after trying SSRIs
6mth tricyclic clomipramine
what is agoraphobia
anxiety about leaving the house or being in a crowded / public place
what age range is agoraphobia most commonly seen in
20-30s
what conditions are associated with agoraphobia
depression
manic disorder
alcoholism
what age range is social phobia seen in
10s-20s
give examples of situations that would cause anxiety/avoidance in a PTx with social phobia
eating in public
public speaking
what is the 1st line management of social phobia
CBT
what is the 1st pharmalogical management choice for social phobia? (also 2nd line mx)
SSRI escitalopram / sertraline
in the mx of social phobia, if a ptx has tried a SSRI with no response, what is the next option
diff SSRI or SNRI venlafaxine
anxiety due to flying, heights, animal, insect, injections or seeing blood are examples of ______. these are distinguished from ‘normal’ fears since they cause _______.
specific phobia
impaired functioning
what is the management of a specific phobia
behavioural therapy +- CBT +- SSRI
what gender is OCD more common in
equal
what age range is OCD more common in
13-25yr
what distinguishes OCD from an anankastic personality
the obsession is unpleasant
do patient’s have insight in OCD
yes, recognised as pointless
how long must S+S be present for a Dx of OCD
most days >2wk
in OCD; checking, cleaning, repeating acts, mental compulsions, ordering, hoarding and counting are all examples of ______
compulsions
in OCD; contamination, fear of harm (locking doors, harm to baby/partner), symmetry, body image, religion, sexual and hoarding are all examples of _______
obsessions
what is the 1st line Mx of OCD
CBT / ERP
what is the 2nd line Mx of OCD
more CBT or SSRI
in OCD, if Mx with a SSRI is unsuccessful, what is the next step
increase SSRI dose
after using SSRIs in the Mx of OCD with no response, what drug class should be used next?
tricyclics (clomipramine)
