Anxiety and OCD

Question 1

What are the physical symptoms of anxiety?

Answer 1

sweating
hot flushes
cold chills
lump in throat
muscle tension/aches/pains
difficulty breathing

Question 2

What are the cognitive symptoms of anxiety?

Answer 2

mentally tense
difficulty concentrating
fear of losing control, going crazy or dying
meta worry - worrying about everything
health anxiety

Question 3

What are the features of a generalised anxiety disorder?

Answer 3

anxiety not fixed on any one thing

anxiety there most of the time

Question 4

What is the criteria for generalised anxiety disorders?

Answer 4

lasting for > 6months
causing signifcant distress or impairement in function
uncontrolable

Question 5

What are the risk factors for generalised anxiety?

Answer 5

female x2

Question 6

What is the typical age of onset of generalised anxiety?

Answer 6

20-40yrs

Question 7

What treatment is recomended for generalised anxiety?

Answer 7

CBT
SSRIs
Benzodiazepines for short term

Question 8

What is the presentaton of Panic disorder?

Answer 8

recurrent attcks of severe anxiety that are unpredictable

may occur with or without agoraphobia

Question 9

At what age do panic disorders present?

Answer 9

late adolesnce to mid 30s

Question 10

What is the pathophysiology behind panic disorders?

Answer 10

increased metabolism in the parahippocampal gyrus of the temporal lobe on PET scans

Question 11

What is the treatment of Panic disorders?

Answer 11

CBT
SSRIs, SNRIs, Tricyclics
Benzodiazepines for short term

Question 12

What is agoraphobia?

Answer 12

fear of leaving the house
fear of travelling alone
fear of being in busy/social situations

Question 13

What is a specific phobia?

Answer 13

marked and persistant fear that is excessive and unreasonable that is triggered by a specific object or situation
the person knows the fear is unreasonable

Question 14

What is the treatment of specific phobias?

Answer 14

CBT and graded exposure to the thing

SSRIs/SNRIs if necessary

Question 15

What is a social phobia? What are the symptoms?

Answer 15

persistent fear of social/performance situations
symptoms:
blushing, shaking
fear of peeing or pooing yourself
fear of vomiting

Question 16

What is the pathophysiology behind social phobias?

Answer 16

bilateral increased activation of the amygdala and decreased cerebral blood flow - normalises on treatment

Question 17

What is the treatment of social phobias?

Answer 17

CBT
SSRI/SNRI
Benzodiazepine

Question 18

What is the mode of action of benzodiazepines?

Answer 18

increase the frequency of the chloride ion channel opening - results in a inhibitory post synaptic potential

Question 19

How long should benzodiazepines be used for - MAX?

Answer 19

2 weeks - otherwise cause problems

Question 20

What is OCD made up of?

Answer 20

obessional thoughts

compulsions

Question 21

Describe the obessional thoughts experienced in OCD?

Answer 21

egodystonic
recognised as the patients own thoughts
sterotyped in the mind

Question 22

Describe the compulsive acts experienced in OCD?

Answer 22

repeated rituals or stereotyped behaviour

recognised as pointless by the patient

Question 23

What is the diagnostic criteria for OCD?

Answer 23

obsessions must be individuals own thoughts
rituals are not pleasant
resistance must be present
obessional thoughts/images/impulses must be repetitive

Question 24

What is the mean age of onset for OCD?

Answer 24

20

Question 25

What is the treatment for OCD?

Answer 25

CBT - including response prevention