Anxiety disorders Flashcards
anx. epi
- 25% lifetime prevalence
- 2:1 F:M
- highly comorbid
4 contibutions to anxiety disorders
- genes
- temperment
- partenting style
- stress exposures
5 DSM anxieties + 2 to know for exam
- specific phobia
- social anxiety
- panic
- agoraphobia
- GAD
+ OCD
+ PTSD
key features to all disorders (3)
- causes clinically significant impairment or distress
- not due to substance or medical problem
- not better explained by other condition
main features of GAD (3)
- exc. anxiety and worry about A NUMBER of events
- over 6 months
- difficult to control worry
2 main feautes of panic
- recurrent panic attacks
2. followed by either persistent concern or worry about panic, or avoidance of behaviors
features of agoraphobia (2)
- fear of not being able to escape situations
2. persistent fear or avoidance of these situations
5 agoraphobic sits.
- public transit
- being in open spaces
- being in enclosed spaces
- standing in line or a crowd
- being outside home alone
3 features of social anxiety
- marked fear of social situation in which the indiv. is exposed to scrutiny by others
- indiv. fears they will act in an embarrassing way
- situation always evokes and they avoid
2 main features of specific phobia
- marked fear about specific thing
2. avoids
2 keys to OCD
- presence of obsession or compulsions or both
2. they are time consuming (>1hour per day)
5 key features to PTSD
- exposure to trauma (can be indirect)
- intrusive sx
- avoidance
- cog. alterations and mood changes
- altered arousal and reactivity
2 main treatments for anxiety
- CBT - waitlist
2. drugs
5 key parts to assessment
- diagnosis
- rule out medical conditions
- co-morbidities
- severity
- patient’s choice of treatment
main med for anx
SSRI
3 reasons for SSRI
- good evidence
- well tolerated
- effective for many common comorbidities
4 less serious SEs of SSRI
- GI distress
- headaches
- agitiation
- insomnia/somnolence
3 more serious SE of SSRIs
- sex
- prolonged QT
- suicide
key to SSRI timing
takes 4 weeks to kick in
what to do for inadequate repsonse
optimization
what to do for partial response
augmentation or combination
what to do when first line fails
switch
what to do once meds help
stay on for at least a year - then slow taper
what is role of benzos (2)
- can use with SSRI for short term
- use for sporadic attacks
- clonazepam
2 benzo cautions
- addictive - watch in substance abusers
2. falls/cog. impariement
