Anxiety Disorders

Question 1

Antidepressants increase __________.

Answer 1

neurogenesis

Question 2

Atrophy/death of neurons is caused by what?

Answer 2

chronic stress, incr glucocorticoids, decr BDNF

Question 3

Antidepressant treatment may normalize ______ levels.

Answer 3

BDNF

Question 4

PTSD was an anxiety disorder in DSM-IV, now in DSM-5 it falls in what category?

Answer 4

Trauma and Stressor-Related Disorders

Question 5

OCD was an anxiety disorder in DSM-IV, now in DSM-5 it falls in what category?

Answer 5

Obsessive-Compulsive and Related Disorders

Question 6

What are risk factors in the development of anxiety disorders?

Answer 6

• personal hx anxiety in child/adolescent years incl marked shyness
• family hx anxiety (or other mental disorder)
• female gender
• stressful life event/traumatic event
• comorbid psychiatric disorder (particularly mood disorder)

Question 7

What are the criteria of separation anxiety disorder?

Answer 7

developmentally inappropriate/excessive fear or anxiety concerning separation from those that individual is attached as evidenced by at least 3 of (at 4 wk in children, 6 mo in adults):

• recurrent excessive distress when anticipating or experiencing separation
• persistent/excessive worry about losing attachment figures or harm to them
• persistent reluctance or refusal to go out, away from hom because of fear of separation
• persistent/excessive fear of being alone or without attachment figure
• refusal to sleep away from home or without attachment figure
• repeated nightmares involving separation
• complaints of physical symptoms when separated

Question 8

What is selective mutism?

Answer 8

Consistent failure to speak in specific social situation in which there is expectation for speaking despite speaking in other situations.

Question 9

What is social anxiety disorder?

Answer 9

• marked fear or anxiety about one or more social situations in which individual is exposed to possible scrutiny by others
• fear out of proportion to actual threat
• fear, anxiety, or avoidance persistent for 6+ mo
• significant distress or impairment in social, occupational, or other important areas
• specify if PERFORMANCE ONLY (e.g. playing musical instrument or public speaking)

Question 10

What is panic disorder?

Answer 10

abrupt surge of intense fear or intense discomfort that reaches peak w/in min, and during which 4 or more occur:

• palpitations, pounding heart, or accel HR
• sweating, trembling, or shaking
• SOB
• smothering, feeling of choking
• chest pain/discomfort
• nausea/abdo distress
• dizzy, unsteady, light-headed or faint
• chills or heat sensations
• numbness or tingling sensations
• derealization or depersonalization
• fear of losing control or ‘going crazy’
• fear of dying

Question 11

What is generalized anxiety disorder?

Answer 11

• excessive anxiety/worry occuring more days than not for 6+ mo
• restlessness
• easily fatigued
• difficulty concentrating/mind going blank
• irritability
• muscle tension
• sleep disturbance

Question 12

What are the most common spheres of worry in generalized anxiety?

Answer 12

family, money, work, illness

Question 13

What is treatment or management of anxiety disorders?

Answer 13

Patient education and psychotherapy (e.g. CBT)

Can use antidepressants, but start at 1/2 dosing and wait longer as compared to treatment of depression.

Benzos also option