Anxiety Disorders Flashcards
excoriation is a disease that involves
skin picking
the instinctual fear center of the brain; hyperactive in most anxiety disorders
amygdala
neurotransmitter behind anxiety, also its location in the brainstem
norepinephrine
locus ceruleus (PONS)
in anxiety disorders, the gender with more cases is
females > males, except OCD
name the drugs that are effective for most general anxiety disorders
serotonergic antidepressants (SSRIs) sertraline, paroxetine, fluoxetine, fluvoxamine, citalopram, escitalopram
alcohol use disorders are prevalent especially in these anxiety disorders
panic disorder, OCD, phobias
a treatment for anxiety disorders that’s as effective as meds
cognitive behavioral therapy
etiologic theory of panic disorder
CO2 sensitivity theory- false suffocation alarm
must rule these things out when diagnosing panic attacks
too much caffeine, stimulants, diet pills, xanthines, heart, lung, thyroid diseases
mainstay of panic disorder treatment
SSRIs “start low, go slow”
- imipramine (MAOI) could be more effective, but has worse side effects
- benzos work, but must be careful
- CBT: breathing techniques, graduated exposure
agoraphobia is marked fear or anxiety about 2 or more of the following
public transportation, open spaces, enclosed spaces, standing in line or being in crowd, being outside the home alone
GAD diagnosis includes 3 or more of the following
restlessness, easily fatigued, difficulty concentrating/mind going blank, irritability, muscle tension, sleep disturbance
highly comorbid disease in GAD
depression
treatment for generalized anxiety disorder
SSRIs/venlafaxine, paroxetine
buspirone
benzos are 2nd, 3rd line of treatment
CBT
fear of scrutiny, humiliation, or embarrassment
social anxiety disorder (social phobia); may be “performance only”; could have panic attacks and lead to social avoidance
best treamtnet for social anxiety disorder, and performance anxiety
SSRIshave best evidence; beta blockers (propranolol) for performance type)
common comorbidities with OCD
major depression, social phobia, Tourette’s*
OCD not same as OC personality disorder; what percent of OCD px’s have premorbid obsessional traits?
15-35%
in OCD, the female incidence equals the males, but in adolescents, there are more males than females. why?
tourette’s
age of onset of OCD
20s, rare after age 35
percentage of Tourette’s patients with compulsions
90% (relation to OCD*)
pathophysiology of OCD
orbitofrontal-limbic-basal ganglia circuit abnormality
*increased metabolism in orbitofrontal and ant cingulate cortices and caudate nuclei
common symptom patterns of OCD
contamination (washing)
pathological doubt (checking)
intrusive thoughts (sexual, aggressive)
symmetry (obsessional slowness)
component of cognitive behavioral therapy good for OCD treatment
exposure-response prevention
