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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

when is anxiety a health problem?

A

If the response is exaggerated, lasts for more than 3 weeks and if it interferes with daily life.

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2
Q

Which gender and by how much is anxiety more common?

A

2x in females

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3
Q

What is neurosis?Asides from anxiety and depression give 3 other symptoms.

A

Maladaptive psychological symptoms, not due to organic causes or psychosis, usually precipitated by stress. Can also show: Fatigue, insomnia, irritability, worry, obsessions and compulsions, and somatisation

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4
Q

Give 5 cognitive, 6 somatic and 2 behavioural symptoms of anxiety.

A

Cognitive:
Agitation, lowered concentration, insomnia, excessive concern, repetitive thoughts and activities.

Somatic:
Tension, tremor, butterflies in stomach, hyperventilation, tingling in hands and chest pain, headaches, sweating, nausea, feeling faint, palpitations, lump in throat.

Behavioural: seeking reassurance, avoiding.

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5
Q

What is needed for an ICD 10 diagnosis of GAD?

A

6 month history of worry/ anxiety about everyday situations.
4 present of:
Autonomic symptoms
Chest/abdomen symptoms, tension symptoms (muscle tension, aches, restlessness)
General symptoms (tingling, numbness, hot flushes)
and
Criteria for panic disorder, hypochondriasis and OCD not met.

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6
Q

What is thought to be the causes of anxiety?

A

Genetic predisposition, stress, life events

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7
Q

Give 4 psychological treatments for anxiety.

A

Listen! (explain there is no fatal disease, that anxiety in itself causes no harm)
Regular exercise
Meditation (mindfulness) (i.e. self help in mild disease)
CBT (best!)
Hypnosis.

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8
Q

What is 1st, 2nd/3rd line medical treatment for anxiety?

A

1st: SSRI (any).
2nd or 3rd: venlafaxine or TCA.
Drugs are if CBT doesn’t’ work/not wanted

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9
Q

When would benzodiazepines or antipsychotics be indicated?

A

Benzos: Sparingly for acute distress and agitation. If trials of several other medicines have had no effect then longer term may be reasonable.
Antipsychotics: generally reserved for acute distress.

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10
Q

When can B blockers be used?

A

For somatic symptoms. They do not help any cognitive symptoms!

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11
Q

What is panic disorder? what do u treat it with?

A

Frequent, discrete panic attacks. Treat with CBT SSRI.

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12
Q

What is OCD characterised by?

A

Obsessions and compulsions.

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13
Q

What are compulsions normally a response to?

A

A response to dealing with the stress of the obsession.

Can often be resisted but if chronic, patient may not be able to.

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14
Q

What % of people experience OCD?

A

2-3%

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15
Q

Give two regions in the brain implicated in OCD.

A

Orbitofrontal cortex, caudate

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16
Q

Give a therapy and two medications used to treat in OCD

A

CBT.

Clomipramine (a TCA) and SSRIs can help

17
Q

What are phobic disorders?

A

A group of disorders in which anxiety is experienced predominantly in certain, well-defined situations that are not dangerous.

18
Q

When do phobias become a disorder?

A

When they cause marked distress and/or significantly affect functioning

19
Q

What is: Agoraphobia, social phobia and simple phobias

A

Agoraphobia: intense, irrational fear of venturing out into open spaces or situations in which help/escape may not be available should excessive anxiety develop.
Social phobia: where we may be minutely observed, there is fear of scrutiny by others. May be blushing, shaking or need to go to the toilet
Simple phobia: Numerous, restricted to specific situations (i.e. arachnophobia)

20
Q

Give 2 therapies and 2 medications that can be used in conjunction for phobias.

A

Therapies: Behavioural therapy, CBT.
Medications: SSRIs, TCAs and pregabalin can be used In conjunction.

21
Q

What is an adjustment disorder?

A

‘Normal depression’
Subjective distress and emotional disturbance, usually interfering with social functioning and performance, that would not have arisen without a stressor. I.e. Abnormally excessive responses to life stresses.

22
Q

What is the difference between an adjustment disorder and a normal reaction to stress?

A

In normal reactions to stress, functioning is not impaired

23
Q

What is an acute stress reaction? How does it get better?

A

Transient reaction to stress lasting hours-days. Dissociation (a daze) then a mix of anxiety, anger, confusion.
Gets better by itself.

24
Q

If symptoms become chronic, give 2 things an acute stress reaction could be?

A

Adjustment disorder (<1 month), PTSD (<6 months)

25
Q

Give 4 common symptoms of PTSD

A

1) Vivid flashbacks and nightmares with automatic arousal, often precipitating anxiety
2) avoidance of things associated with the event
3) sleep and concentration problems
4) easy startling

26
Q

What are 3 disorders common alongside PTSD?

A

Depression, alcohol and drug misuse, anger.

27
Q

How long can it take symptoms to appear in PTSD? Why may this be?

A

Several months to years

Due to there often being denial or suppression of the memory.

28
Q

What type of event is more likely to cause PTSD?

A

Caused by any exceptionally stressful, life-threatening or catastrophic event/situation.
More likely with intentional acts of violence rather than natural events/accidents

29
Q

What is the risk for men and women respectively for PTSD?

A

8% for men, 20% for women after a traumatic experience.

30
Q

Give an area of the brain involved in PTSD

A

Anterior cingulate area, lowered amygdala threshold to fear

31
Q

Give 3 therapies that are effective in PTSD

What medications can be used and when are they indicated?

A

Trauma focussed CBT, eye movement desensitisation and reprocessing, hypnotherapy.
Medicine is 2nd line to therapy, can be used in combination. SSRIs, amitriptyline, mirtazapine and SGA can be used.

32
Q

What is the prognosis of PTSD?

A

About 50% recovered within a year, but depends on the severity of event, coping mechanisms and secondary problems from the event

Psychiatry (21 decks)

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