Anxiety Disorders

Question 1

Definition of anxiety

Answer 1

A response to an anticipated stimulus that is perceived as potentially challenging or harmful
Anticipation of a future threat

Question 2

Defn of anxiety disorder

Answer 2

When anxiety is associated with distress and impairs functioning

Question 3

Defn of fear

Answer 3

Emotional response to real or perceived imminent threat

Question 4

Defn of social phobia

Answer 4

An excessive fear of embarrassment or humiliation in public spaces

Question 5

Non-generalised social phobia

Answer 5

Performance in a particular social situation, such as public speaking, is the main concern

Question 6

Generalised social phobia

Answer 6

Person has multiple fears e.g. speaking, writing, eating in public

Question 7

Agoraphobia

Answer 7

A generalised social phobia in which there is a fear of open spaces, social situations, crowds etc. Associated with avoidance of these stimuli

Question 8

Management of social phobias?

Answer 8

Pharmacological:

• Social phobia –> SSRI or irreversible MOAI
• Generalised social phobia –> classical MOAI or TCA
• Short-term relief –> beta-blockers

CBT:

• Desensitisation
• Cognitive restructuring
• Group therapy

Question 9

Defn of generalised anxiety disorder

Answer 9

A disorder characterised by excessive and continual worry and tension, which the patient experiences as uncontrollable, about a number of daily events and activities

Question 10

Management of generalised anxiety disorder

Answer 10

Pharmacological:

• First line: antidepressant –> SSRI/SNRI
• Second-line: benzodiazepines

Psychotherapy:

• Education
• Cognitive restructuring
• Relaxation exercises
• Worry exposure
• Worry behaviour control (eliminate worry behaviours)

Question 11

OCD defn

Answer 11

A common, chronic condition, often associated with marked anxiety or depression, characterised by obsessions and compulsions

Question 12

Obsession defn

Answer 12

Recurrent and persistent, intrusive thoughts, urges or images that are intrusive/unwanted and that increase anxiety or distress
The individual attempts to ignore/suppress these or neutralize them with another thought/action

Question 13

Compulsion defn

Answer 13

Repetitive behaviours or mental acts that the individual feels driven to perform in response to an obsession, or according to rigid rules
These behaviours are aimed at reducing/preventing anxiety/distress/dreaded situation, however, they’re not connected in a realistic way with what they are trying to prevent

Question 14

Management of OCD?

Answer 14

Psychological:

• CBT: behavioural approach, including exposure and responsive prevention
• Behavioural therapy
• Psychotherapy: groups, supportive

Pharmacological:

• Antidepressants: SSRIs
• Augmentation: antipsychotics (risperidone), especially if psychotic features or schizotypal traits

Physical:

• ECT
• Psychosurgery: for severe incapacitating intractable cases
• Deep brain stimulation

Question 15

PTSD defn

Answer 15

Severe psychological disturbance following traumatic event, characaterised by involuntary re-experiencing elements of the event, with symptoms of hyper-arousal, avoidance and emotional numbing

Question 16

Acute stress disorder defn

Answer 16

Similar to PTSD, with greater emphasis on dissociative symptoms, onset within 4 weeks, lasting 3 days to 1 month, after which the diagnosis changes to PTSD