anxiety disorders Flashcards
what is GAD?
a chronic and pervasive condition characterized by excessive, uncontrollable worry extending across various life domains
what are the physical symptoms seen in GAD?
restlessness, muscle tension, and fatigue, accompanied by cognitive manifestations like difficulty concentrating and disrupted sleep patterns
who is affected by GAD?
females
Commonly comorbid with depression, substance misuse, and personality disorder.
An onset beyond the age of 35-40 years is more likely indicative of depressive disorder or organic disease.
how do you diagnose GAD via ICD 11?
how do you diagnose GAD via DSM 5?
RF for GAD?
Associated risk factors include lower socioeconomic status, unemployment, divorce, renting rather than owning a home, lack of educational qualifications, and urban living.
psychological features of GAD?
Fears, worries, poor concentration, irritability, depersonalization, derealization, insomnia, night terrors
motor symptoms of GAD?
Restlessness, fidgeting, a feeling of being on edge
neuromuscular symptoms of GAD?
Tremor, tension headache, muscle ache, dizziness, tinnitus
GI symptoms of GAD?
Dry mouth, dysphagia, nausea, indigestion, “butterflies” in the stomach, flatulence, frequent or loose bowel movements
cardio symptoms of GAD?
Chest discomfort, palpitations
resp symptoms of GAD?
Dyspnea, tight/constricted chest
Genitourinary symptoms of GAD?
Urinary frequency, erectile dysfunction, amenorrhea
how do you manage GAD?
what is the drug tx in GAD?
1st = sertraline
2nd = SNRI eg duloxetine and venlafaxine
3rd = pregabalin
what are GAD pts <30 at risk of?
warn patients of the increased risk of suicidal thinking and self-harm. Weekly follow-up is recommended for the first month
what is panic disorder?
characterized by the occurrence of recurrent, unexpected panic attacks, each marked by intense fear or discomfort. These episodes prompt persistent worry about future attacks and may lead to avoidance behaviors, altering one’s lifestyle to prevent potential episodes.
who has panic disorder?
adolescence or early adulthood
females
Bimodal incidence, peaking at ages 20 and 50.
Increased risk of attempted suicide with comorbid depression, alcohol misuse, or substance misuse.
how do you diagnose panic disorder based on ICD 11?
how do you diagnose panic disorder based on DSM 5?
clinical features of panic disorder?
management of panic disorder?
step 1: recognition and diagnosis
step 2: cognitive behavioural therapy or drug treatment
step 3: review and consideration of alternative treatments
step 4: review and referral to specialist mental health services
step 5: care in specialist mental health services
what drugs are used in panic disorder?
SSRIs are first-line. If contraindicated or no response after 12 weeks then imipramine or clomipramine should be offered
what are phobias?
Phobias, encompassing specific phobia, social anxiety disorder (SAD), and agoraphobia, represent a cluster of anxiety disorders characterized by excessive and irrational fears.
share common features of avoidance and significant impairment in daily life
what does specific phobia involve?
intense anxiety triggered by a specific object or situation, leading to avoidance behavior
what is social anxiety?
revolves around a marked fear of social scrutiny and performance situations, impeding daily functioning
what is agoraphobia?
anxiety about situations where escape might be difficult or help unavailable
how do you diagnose phobias?
Restricted to highly specific situations such as proximity to particular animals, heights, thunder, flying, exposure to blood, etc.
general clinical features of phobias?
how do you diagnose agoraphobia?
how do you diagnose social anxiety disorder?
how do you manage phobias?
CBT is first-line management for all phobias eg desensitisation, flooding or modelling
If ineffective/severe functional impairment, SSRIs are first-line medical management. Propranolol can be used if somatic symptoms predominate.
