Anxiety Disorders Flashcards
What neurotransmitter imbalances are associated with anxiety disorders?
Increased NE activity
Decreased activity of GABA and Serotonin
Panic Attacks are associated with certain medical conditions:
Mitral Valve Prolapse Asthma PE Angina Anaphylaxis
Patient present with complaint of chest pain, but has normal angiogram: need to consider this on differential.
Panic Attack/Disorder
Characteristic situations avoided in agoraphobia
Bridges Crowds Buses Trains Any open areas outside the home
What is the most effective treatment for specific phobias?
Behavior Therapy: Systemic desensitization (graded and flooding) technique
What can be used during desensitization therapy for phobias in order to control autonomic symptoms?
Short course of Benzodiazepines
or
Beta Blockers
Treatment for Social Anxiety Disorder
The SSRI, Paroxetine, is FDA approved for treatment of this disorder
For diagnosis of PTSD, symptoms must be present for
at least 1 month
PTSD patients have high incidence of these
comorbidities
Substance Use Disorders and Depression
What are the 3 main therapies for the treatment of PTSD?
Prolonged Exposure Therapy
Cognitive Processing Therapy
Eye Movement Desensitization and Reprocessing Therapy
What is cognitive processing therapy?
Modified form of cognitive behavioral therapy in which thoughts, feelings, and meanings of the event are revisited and questioned
What sort of medications should be avoided in the treatment of PTSD?
Addictive medications, especially Benzodiazepines, because of the high rate of substance abuse in these patients
For diagnosis of Generalized Anxiety Disorder, symptoms must be present for…
most days of the week for at least 6 months
What are two non-psychiatric conditions to rule-out when considering diagnosis of GAD?
Medical Conditions (hyperthyroidism) that can cause increased anxiety states and excessive caffeine intake
What is the first line pharmacotherapy for GAD?
SSNRI Venlafaxine
SSRIs
Most effective treatment approach for GAD…
Combination of psychotherapy (CBT) and pharmacotherapy
Obsession
Recurrent and intrusive thought, feeling, or idea that is egodystonic
Compulsion
A conscious repetitive behavior linked to an obsession that, when performed, function to relieve anxiety caused by the obsession
What is the main difference between OCD and OCPD?
In OCD the obsessions and compulsions are egodystonic, whereas OCPD patients do not perceive a problem (egosyntonic).
What illnesses are frequently comorbid with OCD?
Tourette Syndrome and
Attention deficit/hyperactivity disorder
OCD is associated with abnormal neurochemical regulation of…..
Serotonin
OCD is associated with these medical conditions (may be part of PMH)
Head injury
epilepsy
basal ganglia disorders
post partum conditions
What is a major onset trigger of OCD?
Stressful life event found in up to 60% of patients
What is the first-line pharmoacotherapy for OCD?
SSRIs, bu they require higher than normal doses to be effective (in comparison to depression)
