Anxiety Disorders

Question 1

What is the total prevalence of anxiety disorders?

Answer 1

14%, most common mental health disorder

Question 2

Define a panic attack.

Answer 2

An abrupt surge of intense fear or discomfort that reaches peak within minutes with 4 or more specific symptoms.

Question 3

List some symptoms of a panic attack.

Answer 3

Palpitations, sweating, trembling, sensation of shortness of breath, chest pain, nausea, dizziness, chills, paraesthesia, derealisation, fear of losing control, fear of dying.

Question 4

Define Generalized Anxiety Disorder (GAD).

Answer 4

Excessive worry and feelings of apprehension about everyday events with symptoms of muscle and psychic tension causing significant clinical distress or impairment.

Question 5

What are the associated symptoms of GAD according to “WATCHERS”?

Answer 5

Worry
Anxiety
Tension in muscle, Concentratin difficulty Hyperarousal
Energy loss Restlessness
Sleep disturbances.

Question 6

What are the risk factors for Generalized Anxiety Disorder (4)?

Answer 6

Trauma or stress, Childhood stress, Excess caffeine use
Prolonged benzo use

Question 7

What is the pathophysiology of Generalized Anxiety Disorder?

Answer 7

Hyper-responsive amygdala to anxiety cues, involving multiple neurotransmitters: NA, serotonin, dopamine, GABA.

Question 8

Define Social Anxiety Disorder.

Answer 8

Marked fear or anxiety about social situations where the person is exposed to possible scrutiny, lasting more than 6 months.

Question 9

Define Specific Phobia.

Answer 9

Marked fear or anxiety about a specific object or situation that almost always provokes fear and is actively avoided, lasting more than 6 months.

Question 10

Define Panic Disorder.

Answer 10

Recurrent unexplained panic attacks not associated with a situational trigger.

Question 11

What are some non-pharmacological treatments for anxiety disorders?

Answer 11

CBT, relaxation techniques, contingency planning, cognitive methods, psychotherapy.

Question 12

What are some short term management options for anxiety?

Answer 12

Benzodiazepines (e.g., diazepam, lorazepam), beta-blockers (e.g., atenolol).

Question 13

What are some first-line pharmacological treatments for anxiety?

Answer 13

SSRIs, SNRIs (e.g., venlafaxine, duloxetine).

Question 14

What are some second-line pharmacological treatments for anxiety?

Answer 14

Tricyclic antidepressants (TCA), buspirone.

Question 15

What are some third-line pharmacological treatments for anxiety?

Answer 15

Long term benzodiazepines.

Question 16

What is the prognosis for anxiety disorders?

Answer 16

Full recovery is poor, remission rates are low (30% at 3 years), and 70% have residual symptoms at 6 years.

Question 17

Define Separation Anxiety Disorder.

Answer 17

Developmentally inappropriate fear or anxiety concerning separation from those to whom the individual is attached.

Question 18

Define Selective Mutism.

Answer 18

Constant failure to speak in situations where there is an expectation for speaking despite speaking in other situations, not attributed to a lack of knowledge or comfort with the language.

Question 19

Define Agoraphobia.

Answer 19

Fear or anxiety about 2 or more of:
1. Using public transport
2. Being in open spaces
3. Being in closed places, standing in line
4. Being in a crowd
5. Being outside the home alone.

Question 20

What are some physical conditions that can cause anxiety disorders (6)?

Answer 20

1. Pheochromocytoma 2. Diabetes
2. Temporal lobe epilepsy
3. Hyperthyroidism
4. Carcinoid
5. Alcohol withdrawal
6. Arrhythmias