Anxiety Disorders Flashcards
Panic Disorders
- recurrent unexpected panic attacks about which there is persistent concern
- at least one panic attack is followed by more than a month of : persistent concern about more attacks; worry about implications of attack and its consequences; significant change in one’s behavior related to the attacks
Pain attacks =
discrete episodes of intense anxiety which develops abruptly and peak within 10 minutes
Clinical features sx’s of pain attacks
- cardiac: palpitations, tachycardia, chest pain/discomfort
- pulm: SOB, choking feeling
- GI: nausea, abd discomfort
- Neuro: shakiness, dizziness, light-headedness, faintness, parasthesias
- Autonomic arousal: sweating, chills, hot flashes
- Psych: derealization, depersonalization, fear of losing control/going crazy/dying
Management of Panic Disorders
- Benzos(for acute) and antidepressants (for chronic)
- Alpralozam, paroxetine, SSRIs
- psychotherapy
Agoraphobia
- anxiety about or avoidance of places or situations from which escape might be difficult
- may lead to dependence on others or becoming housebound
Agoraphobia management
-psychotherapy
Specific phobias
- marked and persistent fear of circumscribed situations or objects
- exposure to these situations or objects leads to intense anxiety and avoidance which interferes with the patient’s life
- they recognize that the fear is excessive or unreasonable, stimulus is avoided or endured with dread
- fear and avoidance interfere with normal routine or cause marked distress
Agoraphobia examples
-heights, closed spaces, animals, sight of blood
Management of agoraphobia
- Benzos (acutely), adrenergic receptor antagonists
- psychotherapy: CBT, exposure and systematic desensitization
Obsessive compulsive Disorder
- recurrent, intrusive, unwanted thoughts (obsessions) or compulsive behaviors or rituals
- time consuming ax’s (> 1 hr/day) or significantly interfere with normal routine
Obsessive compulsive Risk factors
- mean age of onset = 20s
- chronic course
- Biological features, genetics, behavioral
Obsessions
- recurrent, persistent thoughts, impulses or images characterized by 4 criteria:
1) experienced as intrusive and inappropriate and cause marked anxiety/distress
2) not simply worries about real life problems
3) attempts are made to ignore obsessions or neutralize them with some other thought or action
4) recognize the obsession as a product of our own mind
Complusions
- complulsive behaviors (conscious, standardized, recurrent) take place in response to obsessions or rigid rules
- compulsions are aimed at reducing distress or preventing a dreaded event
- clearly excessive or unconnected in a realistic way with the event to be neutralized
Obsessive compulsive disorder management
- meds: SSRIs, anripaychotics
- psychotherapy
- deep brain stimulation
ambivalence
experience both love and hate toward something
magical thinking
amipotence of thought; thinking about an event can cause it to occur
Social phobia
- fear being exposed to public scrutiny
- fear of behaving in a way which will be humiliating or embarrassing
- persistent fear and avoidance or endurance of social situations with intense distress
- fear is recognized as excessive and unreasonable
Social phobia management
behavior therapy
pharmacotherapy = SSRIs, Benzos, venlafaxine, buspirone, BBs
PTSD
- experienced an event that involved the threat of death, injury or severe harm to themselves or others
- response to the event involved intense fear, helplessness to horror
- frequent re-experiencing trauma in nightmares, flashbacks, or marked arousal when exposed to situations that remind them of the event
- may avoid situations that remind them of the trauma
- sx’s last more than 1 month
PTSD management
- meds = antidepressants, antipsychs, SSRIa, TCAs, MAOIs and anticonvulsants
- psychotherapy: exposure base CBT, family therapy
- eye mvmnt desensitization and reprocessing
Generalized anxiety disorder
- excessive anxiety or worry that is out of proportion to situational factors
- occurs more days than not for 6 mnths
- anxiety associated with muscle tension, restlessness, insomnia, difficulty concentrating, easy fatigability, irritability
GAD management
- meds: benzos, antidepressants (SSRIs)
- paychotherapy: CBT, supportive and insight-oriented
