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PSYCH (Psychiatry) > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

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1
Q

How does an Anxiety Disorder differ from Anxiety?

A

Anxiety = Normal reaction to stressful situations.
Anxiety Disorder = Prolonged duration and experienced at a disabling intensity, affecting the person’s function and overall well-being.

NICE Anxiety : Excessive worry about a number of different events associated with heightened tension.

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2
Q

Give three organic causes of Continuous Anxiety.

A
  1. Hyperthyroidism.
  2. Alcohol.
  3. Caffeine.
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3
Q

Give six organic causes of Episodic Anxiety.

A
  1. Caffeine.
  2. Alcohol.
  3. Drugs.
  4. Arrhythmias.
  5. Hypoglycaemia.
  6. Phaechromocytoma.
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4
Q

Explain the Aetiology of Anxiety using 4 theories.

A
  1. Neurochemical Theory : Dysregulation of neurotransmitters like Noradrenaline, Serotonin, GABA.
  2. Behavioural Theory : Classical condition - negative reinforcement e.g. running away from situation allays fear.
  3. Cognitive Theory : Worrying thoughts are repeated in an automatic way which both induces and maintains an anxiety response.
  4. Attachment Theory : Insecure attachment with parents predisposes an individual to an anxiety disorder.
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5
Q

Explain the Yerkes-Dodson Curve.

A

X-Axis : Arousal; Y-Axis : Performance.

  1. Increasing Attention and Interest.
  2. Optimal Performance and Optimal Arousal.
  3. Impaired Performance - Strong Anxiety.
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6
Q

What is Global Hystericus?

A

A form of somatisation disorder - a subjective feeling of a lump in the throat, unrelated to swelling.

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7
Q

List the 7 methods of management of anxiety.

A
  1. Symptom Control.
  2. Regular Exercise and Meditation (Mindfulness Meditation).
  3. CBT and Relaxation (Best Specific Measures) - education about physiology, techniques for managing arousal, exploring likelihood of events that the patient’s worrying about actually occurring.
  4. Behavioural Therapy - graded-exposure to anxiety-provoking stimuli.
  5. Pharmacological Therapy.
  6. Progressive Relaxation Training - Deep Breathing using Diaphragm and Specific Muscle Group Training.
  7. Hypnosis - inducing progressively deeper trances and concentration on bodily sensations.
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8
Q

What is Neurosis?

A

Maladaptive psychological symptoms that are not due to organic causes or psychosis - usually precipitated by stress.

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9
Q

What is Generalised Anxiety Disorder (GAD)?

A

A mental health condition that causes excessive and disproportionate anxiety and worry that negatively affects a person’s everyday activity - at least 6 months. The worry is not confined to features of another mental disorder or substance abuse or a general medical condition. It must be free-floating (no particular environmental circumstance; persistent).

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10
Q

Give the diagnostic criteria of symptoms of GAD.

A

At least 3 of :-

  1. Restlessness.
  2. Nervousness.
  3. Fatigue.
  4. Poor Concentration.
  5. Irritability.
  6. Muscle Tension.
  7. Sleep Disturbance.
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11
Q

What can be used to investigate the severity of Generalised Anxiety Disorder? (3)

A
  1. GAD-7 Questionnaire.
  2. Assessment for Co-Morbid Mental Health Problems.
    2B. Use HAD to screen in people with physical health problems.
  3. Assessment for Triggers and Contributors.
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12
Q

What is the NICE suggested approach to GAD? (4)

A

Step-wise Approach :
1. Education about GAD and Active Monitoring.
2. Low-Intensity Psychological Interventions e.g. Individual Non-Facilitated Self Help, Individual-Guided Self-Help, Psychoeducational Groups.
3. High-Intensity Psychological Interventions e.g. CBT, Applied Relaxation, Drug Therapy.
3B. Sertraline SSRI - 1st line.
3C. Alternative SSRI/SNRI e.g. Duloxetine, Venlafaxine - 2nd Line.
3D. Pregabalin - 3rd Line.
4. Highly-Specialist Input e.g. Multi-Agency Teams.

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13
Q

Give three techniques to control Panic Attacks.

A
  1. Focusing on breathing (stamping on the spot).
  2. Focusing on senses (cuddling soft, mint-flavoured sweets/gum).
  3. Grounding Techniques.
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14
Q

How is someone in A&E who experiences a panic attack managed? (4)

A
  1. Ask if they already receive treatment for panic disorder.
  2. Undergo minimum necessary investigations.
  3. Not admitted to a medical/psychiatric bed for panic attack.
  4. Referred to primary care for subsequent care.
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15
Q

What is Agoraphobia?

A

Fear of being unable to escape to a safe place (usually home) so fear of open places, confined situations that are difficult to leave without attracting attention. If severe, can make the patient house-bound and onset is mid-20s.

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16
Q

What is PTSD?

A

Post-Traumatic Stress Disorder; mental health problem that one can develop after experiencing traumatic events. DSM-IV : Symptoms must be present for more than 1 month.

17
Q

Give 4 common clinical features of PTSD.

A
  1. Reliving aspects of the trauma e.g. vivid flashbacks, nightmares.
  2. Alertness/Feeling on edge e.g. panicking, sleep disturbance, emotional instability.
  3. Avoiding Feelings/Memories e.g. distractions, emotional numbness.
  4. Difficult Beliefs/Feelings e.g. lack of trust, communication.
18
Q

How is PTSD generally treated?

A
  1. Trauma-Focused CBT.
  2. EMDR - Eye Movement Desensitisation and Reprocessing.
  3. Pharmacological Therapy.
    3A. Venlafaxine (SNRIs) or SSRIs.
    3B. Risperidone.
19
Q

What is OCD?

A

Obsessive-Compulsive Disorder - frequently debilitating and often severe anxiety disorder characterised by obsessions and compulsions.
Obsessions lead to anxiety; anxiety leads to compulsions; compulsions lead to a temporary improvement in anxiety.

20
Q

What is an Obsession?

A

Unwelcome thoughts, images, urges or worries that repeatedly appear in the mind - cause of anxiety. They must be the individual’s own thoughts/impulses and at least one thought or act is still resisted unsuccessfully.

21
Q

What is a Compulsion?

A

Repetitive activities that one does to reduce the anxiety caused by the obsession.

22
Q

How is OCD managed?

A 
Mild :
1. Low-Intensity Psychological Interventions e.g. CBT, ERP (Exposure-Response Prevention).
2. SSRI/More-Intensive CBT.
Moderate/Severe :
1. SSRI + CBT Combined.
23
Q

What is ERP?

A

Exposure-Response Prevention; psychological method involving exposure to an anxiety-provoking situation e.g. dirty hands and stopping them engaging in their usual safety behaviour e.g. washing.

24
Q

How must SSRIs be used in OCD?

A

Continue for at least 12 months to prevent a relapse and allow time for improvement.

25
Q

What is BDD?

A

Body Dysmorphic Disorder - OCD relating to physical appearance e.g. obsession - invisible/very slight imperfection; compulsion - mirrors, skin-picking.

26
Q

What SSRI is specifically used in BDD?

A

Fluoxetine.

27
Q

What is Hypochondriasis?

A

Health Anxiety/Illness Anxiety Disorder - obsessional preoccupation with the idea that they are currently or will be experiencing a physical illness e.g. cancer, HIV, AIDS.

28
Q

Give 4 risk factors for the development of GAD.

A
  1. Age : 35-54.
  2. Being Divorced/Separated.
  3. Living Alone.
  4. Being a Lone Parent.

PSYCH (Psychiatry) (11 decks)

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