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Anxiety disorders Flashcards

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1
Q

Risk factors for GAD

A

Being aged between 35 and 54
Being divorced or separated
Living alone as a lone parent

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2
Q

Diagnostic criteria for GAD

A

Excessive anxiety and worry occurring more days than not for at least six months

Difficult to control the worry

Restlessness

Easily fatigued

Difficulty concentrating

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3
Q

Autonomic arousal symptoms in GAD

A 
Palpitations or pounding heart 
Tachycardia 
Sweating 
Trembling or shaking 
Dry mouth
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4
Q

Step 1 of stepped care model for management of GAD

A

Identification, assessment, education, monitoring

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5
Q

Step 2 of stepped care model for management of GAD

A

Low-intensity psychological intervention
Non-facilitated or guided self-help
Psycho-educational groups

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6
Q

Step 3 of stepped care model for management of GAD

A

CBT/applied relaxation or drug treatment

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7
Q

Step 4 of stepped care management of GAD

A

Specialised drug and/or psychological treatment, multi-agency teams, crisis intervention, outpatient or inpatient care

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8
Q

Pharmacological intervention for rapid response in acute anxiety

A

Sedative antihistamines
Benzodiazepines(should not be used beyond 4 weeks)
Buspirone

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9
Q

First line pharmacological intervention in GAD

A

SSRI or venlafaxine

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10
Q

Which SSRIs are licensed for treatment of GAD

A

Escitalopram

Paroxetine

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11
Q

Which medication can be considered in patients who cannot tolerate SSRIs

A

Pregablin

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12
Q

Definition of panic attacks

A

Must be associated with >1 month’s duration of subsequent, persisting anxiety about recurrence of attacks

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13
Q

Features of panic attacks

A

Attacks usually last at least 10 minutes but their duration is variable

Symptoms must not arise as a result of alcohol or substance misuse, medical conditions or other psychiatric disorders, in order to satisfy diagnostic criteria

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14
Q

Symptoms experienced during panic attacks

A 
Palpitations 
Sweating 
Trembling or shaking 
Dry mouth 
SOB 
Feeling of choking 
Chest pain 
Nausea
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15
Q

Which medications can panic disorders be associated with

A

SSRIs
Benzodiazpine withdrawal
Zopiclone withdrawal

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16
Q

What in the history would suggest a panic disorder with agoraphobia

A

Attacks that arise in an inconsistent or unpredictable way following exposure to a given anxiety-provoking situation or event

17
Q

Associated psychiatric disorders with panic disorders

A

Agoraphobia +/- social phobia

Mood disorders such as depression

18
Q

Step 2 of management of panic disorders

A 
Involve patient's family/carer 
Advise avoiding anxiety-producing substances(caffeine) 
Exclude alcohol or drug misuse 
CBT
SSRIs
19
Q

Which medication can be considered in panic disorder management if SSRIs have not helped

A

Consider imipramine or clomipramine if no improvement after 12 weeks

20
Q

Features of self-help advice for patients with anxiety

A

Give details of books based on CBT principles and contact details of support groups

Promote exercise

Abdominal/diaphragmatic breathing

21
Q

Features of PTSD

A

Re-experiencing flashbacks, nightmares and distressing images

Avoidance of people and situations

Hyperarousal and hypervigilance for threat

Emotional numbing(feeling detached)

22
Q

Management of PTSD for mild symptoms lasting less than 4 weeks

A

Following a traumatic event, single-session interventions are not recommended

Watchful waiting

23
Q

Management of severe PTSD

A

Trauma-focused cognitive behavioural therapy(CBT)

Eye movement desensitisation and reprocessing(EMDR) therapy may be used in more severe cases

24
Q

Pharmacological options in PTSD

A

Should not be used as a routine first-line

Venlafaxine or an SSRI such as sertraline

NICE recommends risperidone in severe cases

25
Q

Physical symptoms of social anxiety

A 
Trembling 
Blushing 
Sweating 
Palpitations 
Chronic insecurity about their relationships with others
26
Q

what are the two forms of social anxiety

A

Generalised social anxiety - affects most, if not all areas of life

Performance social anxiety - only occur in a few specific situations such as public speaking

27
Q

Identification and assessment of social anxiety phobia

A

3-item mini-social phobia inventory(Mini-SPIN)

Do you find yourself avoiding social situations or activities?

Are you fearful or embarrassed in social situations?

28
Q

Initial treatment options for social anxiety disorder

A

Individual CBT
SSRI such as escitalopram or sertraline if CBT is declined
Short-term psychodynamic psychotherapy if meds and CBT declined

Psych (9 decks)

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