Anxiety Flashcards
Generalised anxiety disorder
excessive, persistent, unreasonable anxiety about every day things. People with GAD feel their anxiety is out of their control
Symptoms of GAD
Restlessness, difficulty concentrating, irritability
Physical symptoms- digestive symptoms, muscle spasms, difficulty sleeping- chronic fatigue, sweating, lightheadedness, dizziness, palpitations.
Diagnosis of GAD
Needs to be severe enough to be-
long lasting- most days for at least 6 months
not controllable
causing significant distress/impairment in function
Incidence and prevalence of GAD
lifetime prevalence- 9%
Age onset- 20-40yrs, F>M, chronic fluctuating course
Treatment of GAD
CBT
SSRIs/SNRIs
Pregablin
Benzos- short term only
Panic disorder
Recurrent attacks of sever anxiety/panic which are not restricted to any particular situation or set of circumstances (unpredictable). Typical anxiety symptoms present, often also secondary fear of dying, loosing control, or going mad.
May occur with/without agoraphobia, not due to direct physiological effects of a medication or medical disorder
Agoraphobia
Fear of being in situations where escape may be difficult or that help wouldn’t be available if things went wrong
Incidence and prevalence of panic disorder
lifetime prevalence 2-3%
50-67% also have agoraphobia
onset- late adolescence to mid thirties
10 year follow up- 1/3 unchanged or worse, 1/3 modest improvement, 1/3 well
comorbid with other anxiety disorders, depression, alcohol and drug use
Treatment of panic disorder
CBT, SSRIs/SNRIs/ tricyclics, Benzos (short term
what can trigger panic attacks in susceptible individuals
infusions of lactate, rebreathing air
3 types of phobia
specific phobia
agoraphobia
social phobia
age of onset of phobias
Early onset- social and specific- 80% by early adolescence
Fear recognised as irrational, typified by avoidance and anticipatory anxiety
Agoraphobia
Fear of leaving house, crowds, travelling alone in planes, trains or buses. Avoidance of phobic situation often prominent- can experience little anxiety as a result. Associated with other mental disoreders
Specific phobia
marked persistent fear that is excessive or unreasonable eg pf heights, flying etc
Exposure almost invariably provokes and anxiety response
Treatment of specific phobia
Behavioural therapy- graded exposure/desensitisation
SSRIs/SNRIs if required
Social phobia/social anxiety disorder
Persistent fear of one/more social situations in which the person is exposed to unfamiliar people or to possible scrutiny by others
Individual fears that they will act in a way (show anxiety symptoms) that will be embarrassing
Usually occurs in small social settings
Symptoms of social anxiety
blushing/shaking, fear of vomitting, urgency/fear of micturition/defecation
can result in poor school performance, school refusal etc
Treatment of social anxiety
CBT, SSRIs/SNRIs, benzos
OCD
Obsessional symptoms, compulsive acts must be present for at least 2 weeks and be a source of distress and interference with activites
Symptoms of OCD
Obsessions must be individuals own thoughts, resistance must be present, rituals- not pleasant
epidemiology
no gender bias
mean age onset 20yrs
60-90% experience one major depressive episode
significant morbidity with schizophrenia, Tourettes, darting disorders, trichtomallomania
treatment of OCD
CBT, SSRIs/clomipramine
