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Diagnosis Management 2 > Anxiety and OCD > Flashcards

Anxiety and OCD Flashcards

1
Q

what 3 anxiety disorders frequently occur together in children

A

separation anxiety disorder
GAD
social anxiety disorder

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2
Q

normal time frame for separation anxiety

A

peaks around 9 months and disappears by 2.5 years

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3
Q

what is the key feature of the fear/anxiety in separation anxiety disorder

A

it is developmentally inappropriate

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4
Q

what are typical fears in general anxiety disorder in children related to

A

incompetence

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5
Q

what are the 6 possible additional manifestations of GAD and how many are required for dx

A

At least 1:
-restlessness
-easily fatigued
-mind going blank/difficulty concentrating
-irritability
-muscle tension
-sleep disturbance

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6
Q

what are defining factors of the anxiety experienced by children in social anxiety disorder

A

-the fear is of scrutiny/humiliation
-must be in presence of peers as well as adults

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7
Q

how many manifestation must be present for diagnosis of separation anxiety disorder and for how long

A

at least 3 for at least 4 weeks

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8
Q

8 possible manifestations of separation anxiety disorder

A

-fear of losing/harm to attachment figure
-fear untoward event will lead to separation
-reluctance/refusal to go places without attachment figure
-fear of being alone
-refusal to sleep w/o attachment figure near
-repeated nightmares about separation
-excessive distress when separation is anticipated

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9
Q

what are some typical expressions of anxiety in children and adolescents

A

-sleep disturbance/nightmares
-frequent somatic complaints

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10
Q

what is required for dx of pediatric GAD

A

1 recurrent physiologic sx (restlessness, poor concentration, irritability, muscle tension, etc.)

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11
Q

what are some anxiety remission predictors

A

-younger age when tx initiated
-lower anxiety severity
-no comorbidities
-social anxiety not primary dx

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12
Q

therapy interventions for anxiety

A

CBT
family education
family therapy

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13
Q

what type of CBT is considered first line treatment for anxiety in children

A

exposure based CBT

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14
Q

most common class of meds used for anxiety in children

A

SSRIs

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15
Q

most frequently used SSRIs for anxiety in children

A

fluvoxamine
fluoxetine
sertraline
paroxetine

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16
Q

parental risk factors for pediatric anxiety

A

overprotection
insecure parent-child attachment
parental anxiety

17
Q

frequent precursors to separation anxiety

A

death of a loved one
illness
change in environment
move

18
Q

main difference of insight between children and adults with OCD

A

children more likely to find their obsessions and compulsions reasonable

19
Q

2 most common types of obsessions in children

A

-contamination
-harm

20
Q

Frequent associated features of OCD in children

A

avoidance
indecision
doubt
slow task completion

21
Q

frequent OCD comorbidities in children

A

anxiety
ADHD
tic disorders

22
Q

main treatments for OCD in children

A

CBT and SSRIs

23
Q

what is the basis of CBT in the treatment of pediatric OCD

A

developmentally appropriate exposure coupled with response prevention will lead to decreased anxiety over time

24
Q

order of treatments in childhood OCD

A

trial of CBT prior to medication therapy

25
Q

main SSRIs used in the treatment of pediatric OCD

A

sertraline
fluoxetine
fluvoxamine

26
Q

what are other medications options for OCD treatment besides SSRIs

A

clomipramine
augmentation with abilify for partial responders

27
Q

what medications tend to worsen obsessions/compulsions

A

stimulants

28
Q

what should be done to tx childhood OCD prior to medication

A

trial of CBT

29
Q

age to prescribe sertraline

A

at least 6
50-200mg

30
Q

age to prescribe fluoxetine

A

at least 7
20-60mg

31
Q

age to prescribe fluvoxamine

A

at least 8
up to 200mg

32
Q

age to prescribe chlomipramine

A

at least 10
3mg/kg or up to 200mg
whichever is less

Diagnosis Management 2 (8 decks)

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