Anxiety Disorders Flashcards
define generalised anxiety disorder (GAD)
a disproportionate and uncontrollable widespread worry persisting for >6mnths that induces feelings of apprehension, motor tension and autonomic overactivity
risk factors of GAD
female sex FH of psych disorders childhood adversity environmental stressors chronic/painful illness
clinical features of GAD
depersonalisation derealisation palpitations/pounding due to ⬆️ HR sweating tight chest/chest pain loss of control fear of dying
investigations for GAD
GAD-7 anxiety questionnaire
step one of GAD management
advice and education
self-care advice regarding sleep hygiene and exercise
active monitoring
step two of GAD management
low intensity psychological intervention
step three of GAD management
high intensity psychological intervention
SSRI or SNRI
when can propanolol be offered to GAD patients?
if they have marked somatic symptoms
step four of GAD management
refer for specialist treatment
define panic disorder
recurrent attacks of severe anxiety that is not restricted to particular situations/circumstances occurring for >1mnth
describe a panic attack
discrete episodes of intense, subjective fear where at least 4 characteristic symptoms are present and occur rapidly but peak within 10 minutes
clinical features of panic disorder
breathing difficulties chest discomfort palpitations tingling/numbness in hands + feet shaking sweating dizziness conditioned fear patterns
step one of panic disorder management
assessment, education and advice
reassurance
step two of panic disorder management
advice on avoiding anxiety producing substances
referral to high intensity psychological help
SSRI prescription
step three and four of panic disorder management
reassess condition, consider alternatives and refer to specialist
definition of obsessive compulsive disorder (OCD)
compulsion/obsession present for most days for >2wks that:
originates in the mind
repetitive, unpleasant and unreasonable behaviour
attempts to resist but fails on at least one compulsion
patient receives no pleasure from carrying out compulsion
investigations of OCD
patient risk assessment
management of mild OCD
low intensity psychological treatment
management of mild OCD if non-responsive to low-intensity psychological therapy
SSRI or
high intensity psychological therapy
management of moderate OCD
either high intensity CBT or SSRI
management of severe OCD
high intensity CBT + an SSRI
