anxiety , adjustment disorders

Question 1

anxiety is assoc w what neurotransmitter imbalances

Answer 1

increased activity of NE

decreased activity of GABA, serotonin

Question 2

biological causes of anxiety

Answer 2

see table 4-2, pg 48

Question 3

panic attack must have at least 4 of what symptoms

Answer 3

palpitations
sweating
shaking
SOB
choking sensation
chest pain
nausea or abdominal distress
lightheadedness
depersonalization
derealization (feeling out of reality)
fear of losing control or going crazy
fear of dying
numbness or tingling
chills or hot flushes

Question 4

panic disorder diagnosis

Answer 4

see pg 49

Question 5

tx of panic disorder

Answer 5

best long term tx is SSRIs, esp paroxetine and sertraline (require higher does than for depression)

benzos effec immediately but best used temporarily

tx should continue for at least 8-12 months

Question 6

agoraphobia

Answer 6

fear of being alone in public places

Question 7

agoraphobia often develops secondary to

Answer 7

panic attacks

Question 8

diagnosis for specfiic phobias

Answer 8

pg 51

Question 9

tx for social phobia

Answer 9

paroxetine
beta blockers for performance anxiety
cognitive and behavioral therapies-as adjuncts

Question 10

diagnosis of OCD

Answer 10

pg 52

Question 11

tx for OCD

Answer 11

SSRIs-first line
TCAs also effective

behavioral tx (best outcomes are achieved when both behav and meds are used simultaneously)

Question 12

diagnosis of PTSD

Answer 12

see pg 54 box to left

Question 13

tx for PTSD

Answer 13

antidepressants (SSRIs, TCAs, MAOIs)
anticonvsulants (for flashbacks and nightmares)

therapy: CBT, supportive, psychodynamic
relaxation training
support groups, fam therapy
eye movement desensitization and reprocessing (EMDR)

Question 14

tx for GAD

Answer 14

SSRIs, SNRI
benzos, buspirone

CBT (combo of CBT with meds achieves better results)

Question 15

GAD diagnosis

Answer 15

pg 56