Anxiety and Adjustment Disorders Flashcards
What neurotransmitter imbalances are associated with anxiety disorders?
- Increased NE
- decreased GABA
- decreased 5HT
What serious medical conditions are panic attacks associated with?
- mitral valve prolapse
- asthma
- pulmonary embolus
- angina
- anaphyaxis
How often do people with panic disorder usually suffer from panic attacks?
2x/wk
but can be several times a day to several times a year
What is the typical age of onset of panic disorder?
late teens to early thirties [avg 25]
What is the best long-term treatment for panic disorder?
SSRIs esp paroxetine and sertraline
-if you can’t use SSRI clomipramine, imipramine work
How does the dose of SSRI for panic disorder differ for that of depression?
Higher dose of SSRI for panic disorder
What treatment is effective immediately for panic attacks?
benzos
How long should treatment for panic disorder last?
8-12 months
How long must symptoms be present for specific or social phobia if the patient is under 18?
6 months
What is the most common mental disorder in the US?
phobias
What is used to treat performance anxiety?
b-blockers
What is the difference between systemic desensitization and flooding?
SD is when the patient is gradually exposed to the feared object or situation while being taught relaxation techniques
Flooding is when the patient is directly confronted with their full fear
What pharmacotherapy is used for specific phobias?
usually it is not effective- we rely on systemic desensitization
-short course of benzos or b-blockers during SD to reduce autonomic response
What pharmacotherapy is used for social phobia?
Paroxetine
b-blocker for performance anxiety only
What disorders are frequently comorbid with OCD?
- tourette syndrome
- ADHD
- MDD
- eating disorders
- anxiety disorders
- OCPD
What is the neurotransmitter changes associated with OCD?
abnormal regulation of 5HT
What 4 medical conditions are often associated with OCD?
- head injury
- epilepsy
- basal ganglia disorder
- postpartum conditions
What are the 5 common patterns of OCD?
- contamination and washing
- doubt and checking
- symmetry and slow task performance
- intrusive thoughts WITHOUT COMPULSIONS (thoughts of stabbing infant so remove all knives bc dont actually want to)
- somatic obsessions
What percent of patients with OCD show improvement with treatment?
30
What pharmacological treatment is used for OCD?
- SSRIs in higher than normal dose
2. TCA
What psychotherapy treatment is used for OCD?
Behavioral Therapy:
- exposure and response prevention(ERP)
- relaxation techniques
If pharmacotherapy and behavior therapy fail for OCD, what is the last resort treatment?
ECT or surgery (cingulotomy)
What time criteria differentiates acute stress disorder from PTSD?
PTSD- the event could have occurred anytime in the past, and the symptoms must be present for at least 1 month
ASD- even must have been less than 1 month ago and the symptoms last less than 1 month
What are pharmacological treatments for PTSD?
- SSRI
- TCA (imipramine, doxepin)
- MAOIs
anticonvulsants for flashbacks and nightmares