Anxiety Disorders Flashcards
What are the types of anxiety disorders? (5 things)
- GAD
- Panic disorder
- Phobias
- OCD
- PTSD
What is Generalised Anxiety Disorder (GAD)?
Free floating anxiety most of da time
What are the risk factors for GAD diagnosis? (6 things)
- Female
- FHx of psychiatric disorders
- Childhood trauma (abuse / parents / bullying)
- Environmental stressors (trauma / violence / jobless / poor)
- Substance dependence
- Chronic / painful illness (e.g arthritis)
What are the somatic CF of GAD? (3 things)
- Increased HR
- SOB
- Trembling
What are the 2 different diagnostic criteria for GAD? (2 things)
- DSM-V diagnostic criteria
- ICD-10 diagnostic criteria
They can overlap, so use dem + own Clinical Judgment for diagnosis
What are the DSM-V diagnostic criteria for GAD? (3 things)
- 6+ months excessive disproportionate worrying + unable to control worry + causes distress
- 3+ symptoms happening most of the time, from:
- Restlessness / nervousness
- Being easily fatigued
- Poor concentration
- Irritability
- Muscle tension
- Sleep disturbance
- The worry not caused by different Mental Disorder / Substance Abuse
What questionnaire can be done to assess severity of GAD?
GAD-7 anxiety questionnaire
What conditions does GAD co-morbid w? (5 things)
- Major depression
- Panic disorder
- Phobic anxiety disorders
- Health anxiety
- OCD
What is the NICE Step wise approach for managing GAD? (4 steps)
Step 1: Education abt GAD + Active monitoring
Step 2: Individual/guided Self-help / psychoeducational groups
Step 3: CBT / Applied relaxation / Drug Treatment
Step 4: Highly specialist input (multi agency teams)
What is the first line drug treatment for GAD?
Sertraline (SSRI)
What is a Panic disorder?
Condition where you have regular panic attacks (extreme surge of anxiety symptoms)
How do you grade Moderate vs Severe Panic disorder?
- Moderate = 4+ panic attacks per month
- Severe: 4+ panic attacks per week
What is the Step-wise treatment for Panic disorders? (5 things)
Step 1: Recognition + Diagnosis
Step 2: Primary care treatment (CBT / Drug treatment)
Step 3: Review + Consider alt treatments
Step 4: Review + Refer to Specialist MH services
Step 5: Care in Specialist MH services
What is the FIRST LINE drug treatment for Panic disorders?
SSRI
What are the SECOND LINE drug drug for Panic disorders? (1st line contraindicated / no response @ 12 wks)
Imipramine / Clomipramine
What is a Phobia?
Extreme / irrational fear of something
What are some common Phobias? (2 things)
- Agoraphobia
- Social phobia
What is Agoraphobia?
Fear of going somewhere where ppl r der (stops u leaving da house)
What is Social phobia?
Fear of being w other people (hard to talk to ppl)
What is the treatment for Phobias?
CBT (cognitive behavioural therapy)
What is OCD? (2 things)
Condition involving:
- Obsessions: unwanted thoughts / intrusive images
- Compulsions: repetitive behaviours (you feel you need to do to relieve obsession)
What conditions does OCD co-morbid w? (5 things)
- Anxiety
- Depression
- Eating disorders
- Autistic spectrum disorder
- Phobias
What is the treatment for MILD OCD? (2 things)
CBT including ERP (exposure and response prevention)
What is ERP (Exposure & Response Prevention) (3 things)
- Exposing pt to anxiety provoking situation (e.g having dirty hands)
- Stopping them from engaging in usual safety behaviour (e.g washing hands)
- Helps confront anxiety + habituation –> eventual extinction of response
What is the treatment for MILD OCD not responding to CBT? (2 things)
- SSRI
- More intensive CBT
What is the treatment for MODERATE OCD? (2 things)
- SSRI
- More intensive CBT
What is the specific SSRI for Body Dysmorphic Disorder (BDD)
Fluoxetine
What is the treatment for SEVERE OCD? (2 things)
SSRI + CBT together
What should you do if SSRI is effective for OCD?
Keep them on it for 12 months to prevent relapse
What is PTSD?
Severe chronic disorder that develops after experiencing / witnessing a traumatic event
What are the most common causes of PTSD in Men / Women?
- Men = Combat trauma
- Women = Sexual assault
What conditions does PTSD co-morbid w? (3 things)
- Mood disorders
- Substance use disorders
- Anxiety disorders
What are the CF of PTSD? (4 things)
- Recurring invol memories from trauma
- Recurring nightmares related to trauma
- Flashbacks – feeling like re-experiencing trauma
- Sleep disturbance
How long should symptoms be present for for a PTSD diagnosis?
1+ month
What is the treatment for PTSD? (2 things)
- CBT
- SSRI
What is the FIRST LINE SSRI for PTSD?
Sertraline
What medications should you give PTSD pt suffering from insomnia / nightmares?
Alpha blockers (Prazosin)
