anxiety disorders Flashcards

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1
Q

what can pathological anxiety involve

A

generalised anxiety disorder, phobia, panic disorder

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2
Q

what is anxiety comorbid with

A

depression, substance misuse, another anxiety disorder

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3
Q

prevalence

A

6% of the population- generalised is 2-4%

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4
Q

what type of people does anxiety more affect

A

women, young adults, middle aged

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5
Q

aetiology

A

genetics, biological, childhood- abuse, separations, excessive conformity; stress- financial problems, chronic disease

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6
Q

what is the biological link

A

low levels GABA, heightened amygdala activation

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7
Q

what is the chance of someone having anxiety disorder if first degree relative has it

A

x4

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8
Q

what is panic disorder

A

recurrent episodic severe panic attacks- unpredictable and not restricted to one type of situation

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9
Q

diagnosis panic disorder

A

at least 3 panic attacks in 3 week period

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10
Q

symptoms panic disorder

A

palpitations, sweating, breathless, feeling of choking, chest pain, nausea, dizzy, derealisation, depersonalisation. typically last a few mins

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11
Q

what is first line treatment panic disorder

A

SSRIs, CBT

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12
Q

what are not recommended in panic disorder

A

benzos as these can make worse

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13
Q

what is generalised anxiety disorder

A

generalised, persistent, excessive anxiety or worry bout a number of events the patient finds difficult to control

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14
Q

diagnostic GAD

A

at least 3 weeks (ICD10), or >6m (DSM)

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15
Q

what is anxiety associated with in GAD

A

subjective apprehension, increased vigilance, restless and on edge, sleeping difficulties, autonomic hyperactivity

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16
Q

ddx GAD

A

withdrawal from drugs, excessive caffeine consumption, depression, psychosis, organic- thyrotoxicosis, hypoglycaemia, phaechromocytoma,

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17
Q

first line treatment GAD

A

SSRI s and CBT

18
Q

what is agarophobia

A

fear of places and situations and avoidance

19
Q

management agarophobia

A

CBT, graded exposure. SSRIs if not working

20
Q

what is social phobia

A

persistent fear of social situations in which exposed to unfamiliar people or scrutiny

21
Q

management social phobia

A

CBT, self help, graded exposure, social skills training

22
Q

specific phobia management

A

graded exposure therapy and response prevention.

23
Q

what can obsessions be

A

thoughts, images, impulses, ruminations, doubt.

24
Q

difference between obsessions and compulsions

A

obsessions- thoughts. compulsions- repetitive behaviour

25
Q

prevalence OCD

A

2-3% population M=F.

26
Q

diagnosis OCD

A

obsesisons and compulsions for 1+ hours a day and for >2weeks and distressing/interfere with activities

27
Q

treatment OCD

A

CBT- exposure and response prevention, SSRIs or clopiramine

28
Q

when is OCD typically onset

A

adolescence

29
Q

aetiology OCD

A

genetics (OCD or tourettes in family), parental overprotection, may occur after strep infection in children

30
Q

neurochem change in OCD

A

decr serotonin. abnormalities in cortico striatal thalamic circuit (mediates social behaviour)

31
Q

OCD course

A

may follow an episodic or chronic course

32
Q

poorer prognosis in OCD

A

with prominent compulsions, comorbid tic disorders, persistent life stresses, premorbid anankastic personality

33
Q

what is body dysmorphic disorder

A

obsessional preoccupation with imagined or mild physical defects- mirror gazing, comparing features with others, reassurance seeking

34
Q

what is PTSD

A

severe psychological disturbance following a traumatic event

35
Q

when do symptoms PTSD arise

A

arise within 6 months of traumatic event, or present for at least 1 month.

36
Q

ICD10 and DSM diagnosis of PTSD

A

> 2 of: difficulty falling/staying asleep, irritability or anger outbursts, difficulty concentrating, hypervigilance, exaggerated startle response

37
Q

risk of diagnosing PTSD after traumatic event

A

8-13% men, 20-30% women

38
Q

treatments PTSD

A

trauma focused CBT, eye movement desensitisation and reprocessing therapy (EMDR), drugs for symptoms

39
Q

features PTSD

A

persistent intrusive thinking, avoidance, numbing/detachment from others, increased arousal

40
Q

prognosis PTSD

A

50% recover within a year, 30% chronic course. outcome depends on- good social support, response by others, no further traumatic events, premorbid personality