Anxiety Disorders Flashcards
What is the most common mental disorder in the united states?
Anxiety disorders
What is the epidemiology of anxiety disorders?
nearly 1 in 5 have a disorder
Females to males are 2:1 (30%:19%)
Highly treatable, but only 1/3 receive treatment
What are 4 categories to consider what makes anxiety pathologic?
Autonomy- if it happens without provocation
Intensity- disproportionate to stressor
Duration- longer than expected
Behavior- coping strategies are not enough
Name 5 neurotransmitters involved in anxiety
Serotonin NE GABA Glutamate Dopamine
What symptoms are necessary for the diagnosis of a panic attack?
4 or more of the PANICS symptoms
Define panic disorder
Recurrent, unexpected panic attacks without an identifiable trigger
At least one of the attacks was followed by a month or more of the following: anticipatory anxiety, significant, maladaptive change in behavior
Is there a genetic component to panic attacks/panic disorder?
Mild genetic component
What are the two most commonly associated anxiety-related comorbidities with anxiety disorder?
1st: agoraphobia
2nd: GAD
What is the most common non-anxiety disorder associated with panic disorder?
MDD
Describe the theory behind panic disorder
Neurocircuitry theorizes that panic disorder is caused by abnormally sensitive fear network, centered in the amygdala
GABA, serotonin and NE implicated
What are the first line treatments for panic disorder?
SSRIs, SNRIs
What are the second line treatments for panic disorder?
TCAs, MAOs
What is a good bridging therapy for panic disorder when prescribing SSRIs?
benzodiazepines
While waiting for the antidepressant effect to kick in, also treat with benzodiazepines
Cognitive behavioral therapy is also indicated
What are the criteria for anxiety?
Marked fear/anxiety over 2+ of the following situations
- Using public transport
- Being in enclosed spaces
- Being outside of the home alone
- Being in open spaces
- Standing in line/being in a crowd
Fear, anxiety or avoidance > 6 months
What is the primary treatment for agoraphobia?
Systematic desensitization
What drugs can be used in the treatment of agoraphobia?
Antidepressants; SSRIs, SNRIs, TCAs
+/- short term benzo use
Rank GAD, specific phobias and social anxiety in order of most common to least common
Specific phobia > social anxiety > GAD
in general, nearly all anxiety disorders occur more commonly in females than males. Which specific anxieties are an exception?
Blood, injection and injury
M=F
Panic disorders, agoraphobia and GAD are treated with antidepressants, CBT and benzos. Which one can also be treated with buspirone?
GAD
Which anxiety disorder is treated with propranolol in place of benzos?
Social phobias
-Think of a beta blocker being prescribed before giving a presentation
When you think of buspirone, what disorder do you think of?
GAD
What is the epidemiology of selective mutism?
M=F
<5 years old
Mostly outgrown
What are the big 3 psychiatric comorbidities?
- Other anxiety disorders
- Depression
- Substance abuse
What is the main difference between acute stress disorder and PSTD?
Timing
ASD is between 3 days and 1 month
PTSD is 1 month after the traumatic event occured