Anxiety Disorders

Question 1

1- What is GAD?

2- What is the prevalence of GAD?

3- How long must the symptoms be present to diagnose GAD?

4- What can be used to assess the severity of GAD?

5- What are some common symptoms of GAD?

Answer 1

1 - Generalised anxiety disorder worry constantly about numerous, often seemingly trivial things but there is no obvious stimulus to the anxiety (unlike a phobia).

2- Lifetime prevalance of about 6%.

3- Symptoms must be present for 6 months to diagnose.

4- GAD-7

5- Worry mnemonic

Someone who has GAD will WORRY

W Women. GAD is twice as common in females as males
O Obsessions. This isn’t OCD but it is common to obsessively worry
R Restricitve. GAD causes problems in functioning normally
R Restlessness. A common symptom along with other physical symptoms
Y Yawning. Insomnia and feeling tired.

Question 2

1- What is OCD?

2- How does OCD differ from Anankastic Personality Disorder (APD)?

3 - Use the TOUCH mnemonic to describe OCD.

Answer 2

1 - Obsessive compulsive disorder - People with OCD develop a range of intrusive unwanted thoughts or images that they find distressing. This is referred to a ego dystonic (a thought/feeling that is unpleasant).

2- Anankastic Personality Disorder (APD) when the belief that the person has is in keeping with their feelings (ego syntonic)
Example: OCD : “I have sexual thoughts about my mother which distress me”
APD : “All my books should be stored alphabetically and I am happy when they are”

3- MNEMONIC: People with OCD may often TOUCH objects such as light switches/desks etc

T Thoughts. The obsessions are initially intrusive thoughts
O Obsessive. The patient begins to obsessively worry
U Unwanted, unpleasant thoughts that cause compulsions
C Compulsions. An urge to carry out an action or thought such as Cleaning/Counting/Checking
H Hand washing – a common compulsion

Question 3

1- What is a panic disorder ?

2- Use the PANIC mneomic to describe symptoms of a panic disorder.

Answer 3

1- People with panic disorder do experience panic attacks … but they occur suddenly, out of the blue with no obvious trigger

2- P Palpitations and other physical symptoms.
A Abrupt. This doesn’t slowly build up, the person has sudden
N Numbness and tingling feelings.
I Irrational. People believe they are about to die or will go mad.
C Choking. Shortness of breath and difficulty breathing are common symptoms

Question 4

1- What is PTSD ?

2- Use the pnuemonic FAINTS to describe symptoms of PTSD.

Answer 4

1- . A diagnostic criteria is that the trauma is extreme and out of keeping with normal unpleasant human experiences – so failing an exam, having a relationship breakup are normal experiences – being raped or almost murdered are not.

Following the trauma the person experiences ‘reliving events’ such as flashbacks, nightmares and intrusive memories when they re-experience the trauma. This can lead to avoidance of situations that may trigger memories of the trauma.

2- F Flashbacks. Reliving the trauma
A Avoidance. Avoiding reminders of the trauma alleviates the symptoms
I Intrusive Thoughts. Unable to stop intrusive memories of the traumatic event
N Nightmares and insomnia are common symptoms
T Trauma. PTSD occurs in response to a horrific trauma
S Self-medication: substance misuse (alcohol/drugs/medication)