Anxiety Disorders Flashcards
what are the autonomical symptoms of anxiety?
Gastrointestinal:
- dry mouth
- swallowing difficulties
- dyspepsia, nausea, wind
- frequent loose motions
Respiratory:
- tight chest, difficult in inhaling
Cardiovascular:
- palpitations/missed beats
- chest pain
Genitourinary:
- frequency/urgency of micturition
- amenorrhoea/dysmenorrhoea
- erectile failure
CNS:
- dizziness and sweating
what are the psychological symptoms of anxiety?
- fearful anticipation
- irritability
- sensitivity to noise
- poor concentration
- worrying thoughts
what are some other symptoms of anxiety?
Muscle tension:
- tremor
- headache
- muscle pain
Hyperventilation:
- causing CO2 deficit hypocapnia
- numbness tingling in extremities may lead to carpopedal spasm
- breathlessness
Sleep disturbance:
- initial insomnia
- frequent waking
- nightmares and night terrors
type of phobias
- agoraphobia
- social phobia
- specific (isolated) phobias
how is generalised anxiety disorder (GAD) classified by the ICD-11?
- persistent (several months) symptoms not confined to a situation or object
- all the symptoms of human anxiety mentioned earlier can occur: psychological, autonomic, muscle tension, hyperventilation, sleep disturbance
differential diagnosis anxiety disorders
Psychiatric conditions:
- depression
- schizophrenia
- dementia
- substance misuse
Physical conditions:
- thyrotoxicosis
- phaeochromocytoma
- hypoglycaemia
- asthma or arrhythmias
GAD epidemiology
- Anxiety disorders are the world’s most common mental disorders, affecting 301 million people in 2019.
- More women are affected by anxiety disorders than men.
- Symptoms of anxiety often have onset during childhood or adolescence.
- Approximately 1 in 4 people with anxiety disorders receive treatment for this condition.
GAD aetiology
In general terms GAD for instance is caused by a stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood.
GAD management
Counselling:
- clear plan of management
- explanation and education
- advice re caffeine, alcohol, exercise etc.
Relaxation training:
- group or individual
- DVDs, tapes or clinican led
Medication:
- sedatives have high risk dependency
- antidepressants SSRI or TCA
CBT
what are the key features of phobic anxiety disorders?
- same core features as GAD
- ONLY in specific circumstances
- person behaves to avoid these circumstances ‘phobic avoidance’
- sufferer also experiences anxiety if there is a perceived threat of encountering the feared object or situation ‘anticipatory anxiety’.
how does the ICD-11 classify social phobia?
- inappropriate anxiety in situations where person feels observed or could be criticised e.g. restaurants, shops or any queues, public speaking.
- symptoms are any of the anxiety cluster mentioned above but blushing and tremor predominate
what are the core features of OCD?
experience of recurrent obsessional thoughts or compulsive acts.
OCD epidemiology
- overall one year prevalence is 2%
- equally affects men and women
- aetiological theory: genetic e.g. gene coding for 5HT receptors, 5HT function abnormalities.
OCD management
- good history and MSE exclude depressive illness
- general measures: education and explanation, involve partner/family
- serotonergic drugs: SSRIs, clomipramine
- CBT
- Psychosurgery
how does the ICD-11 classify PTSD?
Delayed and/or protracted reaction to a stressor of exceptional severity e.g. combat, natural or human caused disaster, rape, assault, torture, witnessing any of the above.
