Anxiety disorders Flashcards
Diagnosis of GAD?
> 4 symptoms present at least every day for 6 months
Psychological management includes self help books, self guided CBT on websites and if ineffective then CBT sessions or relaxation sessions with therapist. How long are the sessions?
12-15 weeks
What is the pharmacological management of GAD?
- SSRI- doesnt work increase dose or switch to other SSR
- SNRI
- Pregabalin
If palpitations- then B blocker (atenolol) or Pregabalin
Short term acute Benzodiazepenes eg Lorazepam- only use 1-2 weeks due to dependence
What are the 5 sub types of specific phobias?
Animals, blood/injury/needles, natural aspects of environment, situational and other
Management of specific phobias?
- Sensitization therapy
- Flooding
What are social phobias?
Excessive anxiety symptoms which arise in particular social situations resulting in the desire to avoid the situations
Also associated with excessive worry of being embarrassed, humiliated or others noticing how anxious they are
What is the management of social phobias?
- CBT
2. Pharamcological- SSRI’s or MOAs eg Phenelzine
What are agaraphobias?
Anxiety which arises due to particular situations or settings in which escape is difficult or embarrassing leading to avoidance/ ie feeling of being trapped
What is the epidemiology of agaraphobias?
Two peaks of incidence:
- 15-35
- Older age associated with physical fraility and anxiety about exacerbating medical illness or having an accident
What is the psychological and pharmacological management of agaraphobia?
Psychological- CBT and graded exposure
Pharmacological- same as panic disorder
What is the pharmacological management of panic disorder?
- SSRI’s
- Tricylics (Imprimanine) or SNRI’s/MAOI’s
- If above doesn’t work in 3 months then add Benzodiazepene, or atypical antipsychotic (Risperidone, or Olanzapine)
Psychological management of panic disorder?
CBT
Address comorbid alcohol and substance misuse
What are the differentials for panic disorder (include physical)
Other anxiety disorders- agaraphobia Mood disorders Medical illnessess - Endocrine: Cushings, phaechromocytoma, Hypoglycaemia, hyperthyroidisim, hyperparathyroidism - Cardiac: supraventricular arrythymias, mitral valve prolapse, MI -Resp: HSV. COPD, asthma epilepsy anaemia
What is the ICD-10 diagnosis of OCD?
- Obsessions and compulsions present for most days for at least 2 weeks
- Have to be distressing and impair functioning
- Recognised as originating from the patients own mind and repetitive and recognised as being excessive and unreasonable
- Patient tries resisting them and no pleasure from carrying out compulsion
What are the comorbidities associated with OCD?
- Anxiety disorders- social phobias, specific phobia, panic disorder, PTSD
- depressive disorder
- Eating disorder
- Tics and tourette syndrome
