Anxiety and Adjustment Disorders Flashcards
Cardiac sx of Anxiety
Palpitations, tachycardia, hypertension
Neuro sx of anxiety
Dilation of pupils (mydriasis), dizziness, light headedness, hypErreflexia, tremors, tingling in peripheral extremities
Neurotransmitter imbalances associated with anxiety
GABA and serotonin decrease, increase in norepi
Anxiety develops more frequently in which socioeconomic group
higher socioeconomic groups
Panic Attacks Criteria
Palpitations, Abdominal distress, Numbness, nausea, Intense fear of death, Chocking, chills, chest pain, Sweating, Shaking, shortness of breath
(PANICS)
discrete periods of heightend anxiety and fear that classically occur in patients with panic disorders
Panic attacks (also seen with phobic disorders, PTSD)
When do panic attacks usually peak? when do they resolve? (in minutes)
peak within 10 minutes, resolve in less then 25 minutes
How many of the PANIC sx must a patient have to be diagnosed with a panic attack
at least 4
What conditions are panic attacks associated with?
Mitral Valve Prolapse, Pulmonary Embolism, Asthma, angina, and anaphylaxis
characterized by spontaneous recurrent panic attacks with no obvious precipitant
Panic disorder
Panic disorder patients suffer from panic attacks how often?
average of 2 times per week to several times per day
To qualify for panic disorder, at least one of the attacks must be followed by a minimum of 1 month of the following:?
Persistent concern about having additonal attacks, worry about the implicaions of the attack (losing control or “going crazy”
a significant change in behavior related to the attacks
Medical DDx of Panic Attacks/Disorder
CHF, angina, MI, thyrotoxicosis, temporal lobe epilepsy, MS, pheochromocytoma, carcinoid syndrome, COPD
Medication/drugs DDx of Panic Attacks/Disorder
Amphetamines, Caffeine, nicotine, cocaine, hallucinogen intoxication, alcohol or opiate withdrawl
panic disorders are more common in which sex
female (2 to 3 times more)
Onset and genetic component of panic disorders?
Usually late teens to early thirties (avg 25), 4-8x greater risk in first degree relatives
Characteristic situations avoided in Agoraphobia?
bridges, crowds, buses, trains, or any open areas outside the home
fear of being alone in public places
agoraphobia
Tx of panic disorder?
SSRI’s (paroxetine and sertraline (zoloft)) start at low doses and increase slowly. higher doses are for depression
if a person is under 18 how long must they have a specific phobia for you to diagnose them?
at least 6 months
Performance anxiety is often treated with?
beta blockers
most common mental disorders in the united states are?
phobias
Tx for specific phobias?
Behavior therapy is most effective
Tx for social anxiety disorder?
paroxetine (paxil)
recurrent and intrusive thought, feeling or idea that is egodystonic
obsession
conscious repetitive behavior linked to an obsession that when performed functions to relieve anxiety caused by the obsession
compulsion
patients with OCD often initially seek help from who?
nonpsychiatric physicians. (i.e dermatologist for their skin problems from excessive hand washing)
OCD tx?
first line is SSRIs and second line is TCAs (clompiramine)
often requires higher doses then depression
what if a patient doesn’t think there is anything wrong with their obsessions?
obsessive-compulsive personality disorder
requires the presence of a traumatic experience, persistent avoidance, hyperarousal state, and reexperiencing the traumatic event all for more than a month
PTSD
Which class of medications should be avoided in the treatment of PTSD because of the high rate of substance abuse in these patients
benzos
excessive anxiety and worry about daily events and activities for at least 6 months
Generalized anxiety disorder
