Anxiety disorders Flashcards
List three models of stress
Biomechanical engineering
Medicophysiological
Psychological (transactional)
Give two main types of coping mechanism
Problem-focused
Emotion-focused
List the main symptom groups associated with anxiety
Psychological arousal Autonomic arousal Muscle tension Hyperventilation Sleep disturbance
List the features of psychological arousal
Fearful Anticipation Irritability Sensitivity to noise Poor concentration Worrying Thoughts
List the symptoms associated with muscle tension in anxiety
Tremor
Headache (bilateral, frontal/occipital)
Muscle pain
List the symptoms/signs associated with hyperventilation
Hypocapnia
Numbness/tingling in extremities
Carpopedal spasm
Breathlessness
List the features of sleep disturbance in anxiety disorders
Initial insomnia
Frequent waking
Nightmares and night terrors
(not early morning wakening)
List the GI features of autonomic arousal
Dry mouth
Swallowing difficulty
Dyspepsia, nausea
Frequent loose bowel movements
List the respiratory and CVS features of autonomic arousal
Tight chest
Difficulty inhaling
Palpitations/missed beats
Chest pain
List the genitourinary features of autonomic arousal
Frequency/urgency of micturition
Amenorrhoea
Erectile dysfunction
List the CNS symptoms of autonomic arousal
Dizziness
Sweating
What is the difference between generalised anxiety disorder and phobias?
GAD occurs persistently, whereas phobias are linked to specific circumstances
What is panic disorder?
panic attacks occur intermittently but are not associated with a specific object/place/circumstance
What psychiatric conditions should be considered in the differential diagnosis for someone presenting with anxiety?
Depression
Schizophrenia
Dementia
Substance Misuse
What physical conditions should be considered in the differential diagnosis for someone presenting with anxiety?
Thyrotoxicosis
Phaeochromoctoma
Hypoglycaemia
Asthma and or Arrhythmias
What are the management options for anxiety disorders?
Counselling, including education
Relaxation training
Medication
CBT
What sort of education can help patients with anxiety?
Explanation of physical stress response etc
Advice re caffeine, alcohol, exercise etc
What medications can be used to help patients with anxiety
Antidepressants (SSRIs or TCAs)
Sedatives occasionally used but high risk of dependency
What symptoms are most prominant in social phobia?
Blushing
Tremor
What issues may be specifically addressed in CBT for patients with social phobia?
o Negative views of self
o “Safety barriers”
o Unrealistically high standards
o Excessive self-monitoring
What is agoraphobia?
anxiety and panic symptoms associated with places or situations where escape may be difficult or embarrassing, leading to avoidance
What sorts of thoughts are often experienced by patients with OCD?
Obsessional thoughts:
• Ideas, images or impulses
• Occurring repeatedly not willed
• Unpleasant and distressing (often the antithesis of personality type)
o Obscene
o Violent or senseless
• Recognised as the individual’s own thoughts
What are the key features, besides obsessional thoughts, of OCD?
Compulsive acts or rituals:
• Stereotypical behaviours repeated again and again
• Not enjoyable
• Not helpful i.e. do not result in useful activity
• Often viewed by sufferer as
o Preventing some harm to self or others; “magical undoing”
o Viewed as pointless and resisted with key anxiety symptoms accompanying resistance
What medications can be used to treat patients with OCD?
• Serotonergic Antidepressant Drugs
o SSRI eg Fluoxetine
o Clomipramine
