Anxiety Disorders Flashcards
Anxiety Disorder
Anxiety is an emotional state commonly caused by the perception of real or perceived danger that threatens the safety of an individual.
Anxiety Disorder Epidemiology
-4% prevalence
-Majority don’t receive treatment
-Women
-Usually before the age of 30
Anxiety Disorder Etiology
Vulnerability
-Genetic predispositions
-Neurobiological
adaptations of the
central nervous system
-Childhood adversity
Stress
-Occupational
-Traumatic experience
Anxiety Neurotransmitters
-Neropinephrine
-Serotonin
-Corticotrophin-releasing factor (Precursor de cortisol)
-GABA
-Dopamine
-Cholecystokinin (Induce panic)
Generalized Anxiety Disorder (GAD)
Hallmarks are excessive, persistent, and unreasonable worries about everyday things
GAD Epidemiology
-Female
-Age 30-59
-Developed Countries
-European Decent
GAD Noradrenergic Model (Norepinephrine)
The Locus ceruleus serves as an alarm center, releasing high NE and stimulating the sympathetic nervous system (fight or flights response).
-High NE lead to downregulates α2-adrenoreceptors
GAD Serotonin Model
High cortisol levels increase SERT (reuptake of 5-HT). Low serotonin in the synaptic cleft.
GAD GABA Receptor Model
There is low levels of GABA neurotransmitter, less efficient GABA-A receptors, or both (GABA produce relajacion y sueño)
GAD Clinical Presentation
Psychological and Cognitive Symptoms
-Excessive Anxiety
-Tener los nervios de punta
Physical Symptoms
-Restlessness
-Fatigue
GAD Diagnostic
Excessive anxiety and worry for at least 6 months
Present three or more of the following:
-Restlessness
-Fatigue easily
-Difficulty concentrating
-Irritability
-Muscle tension
-Sleep disturbance
Not attributed to other medical condition or medication
GAD Complications
-Depression and increased risk of suicide
-Cardiovascular-related mortality
-Substance Abuse
Panic Disorder (PD)
Consists of a series of unexpected (spontaneous) panic attacks involving an abrupt surge of intense fear or intense discomfort.
PD prevalence
-Women
-Hispanics and American Indian
-Age of 30-40
PD Complications
-Agoraphobia is the hallmark complication. (Cambio maladaptivo)
-Depression and Suicide attempt
PD Pathophysiology
-Panicogens alter the brain pH balance in panic-prone individuals.
-Decreased GABA concentration
-Decreased Serotonin concentration
Higher NE than in GAD
PD Clinical Presentation
Psychological Symptoms
-Fear of Dying or losing control
-Depersonalization or Derealization
Physical Symptoms
-Chills
-Trembling
-Nausea and Dizziness
-Palpitations
-SOB
PD Diagnostic
-4 or more of the clinical presentation
-One or more months patients experience Agoraphobia, concern on experience other panic attacks and anxiety.
-Not attributed to medical condition or medication.
Post-Traumatic Stress Disorder (PTSD)
Exposure to terrifying or lifethreatening trauma may induce PTSD.
PTSD Prevalence
-Male (Especially for rape)
-Accidents is the second most common cause to cause PTSD
PTSD Pathophysiology
Intrusive and Hyperarousal Symptoms
-Amygdala sobre actividad y no
disminuye por la corteza prefrontal
-El hippocampus recuerda eventos
traumáticos activando síntomas
intrusivos.
PTSD Clinical Presentation
-Intrusion Symptoms
-Avoidance Symptoms (Deficiency of serotonin)
-Persistent Negative alterations in thinking and mood
-Hyperarousal symptoms
PTSD Diagnostic
-Directly experiencing a traumatic event
-Witnessing, in person, the events as it occurred to others
-The disturbance las more than 1 month.
- ≥ 1 Intrusion Symptoms
- ≥ 1 Avoidance Symptoms
- ≥ 2 Negative Alterations in Thinking and Mood
- ≥ 2 Hyperarousal Symptoms
Obsessive-Compulsive Disorder (OCD)
A chronic, disabling illness characterized by the two core symptoms; Obsessions and Compulsions
OCD prevalence
-Female
-More common in male during childhood vs female in adulthood
OCD Cortico-Striatal-Thalamic-Cortical Circuit (CSTC)
Direct Pathway
-Al inhibir la sustancia nigra y Globus
Palidus, activa el tálamo que
contribuye a las compulsiones
Indirect Pathway
-Al inhibir el Globus Palidus externo,
no se puede desactivar el tálamo y
reprime el comportamiento no
deseado contribuyendo a las
obsesiones.
OCD Clinical Presentation
Obsessions
-Repetitive Thoughts
-Repetitive Images
-Repetitive Urges
Compulsions
-Repetitive Activities
-Repetitive Mental Acts
OCD Diagnostic
-Presence of Obsession, Compulsion or both
-Symptoms consumes more than one hour daily
-Not attributed to medical conditions or drugs
