Anxiety Disorders Flashcards
Skaggs
What is Generalized Anxiety Disorder?
Excessive and persistent worrying that is hard to control, causes significant distress or impairment and occurs on more days than not for AT LEAST 6 MO
T/F GAD is moderately heritable?
TRUE
Pathognomic feature of GAD?
excessive and persistent worrying
What are the 6 symptoms seen in GAD?
Restlessness, feeling on edge Easily fatigued Difficulty concentrating Irritability Muscle tension Sleep disturbance
How many symptoms must a adult have for GAD?
> 3
How many symptoms must a child have for GAD?
> 1
What screening tool is used for GAD?
The General Anxiety Disorder 7 (GAD-7)
What is the treatment for GAD?
Cognitive behavioral therapy + SSRI
What is the 1st line med for txt of GAD?
SSRI
What is the 2nd line med for txt of GAD?
TCA
If patients don’t respond to 1st or 2nd line med txt for GAD what is used?
Benzo’s
T/F GAD is chronic?
TRUE
What age does GAD disappear?
50 yr
What is GAD replaced with after age 50y?
Undifferentiated Somatization disorder
In patients with coronary disease there is an association between what?
anxiety and mortality
Panic attack is seen in what age and sex?
all ages mostly female
What is panic attack?
abrupt surge of intense fear, reaching a peak within minutes
How many symptoms should develop abruptly in Panic attack?
> 4
At least 1 of two things must be met for diagnosis of panic attack?
- worry about additional attacks
- maladaptive change in behavior
What is the txt for panic attack/disorder?
CBT w/ meds
What are 1st line meds used for panic attack?
SSRI
What are 2nd line meds used for panic attack?
SNRI and TCA
What TCA works best for panic attack?
Imipramine (Tofranil)
What is FDA approved for panic attack txt?
Benzo’s
What does not work for the txt of panic attack?
Bupropion
What can reduce panic attack symptoms?
exercise
When should panic attack be considered a diagnosis of exclusion?
in pts that meet criteria for life threatening illness
What is Agoraphobia?
fear or anxiety about and/or avoidance of situations where help may not be available or where it may be difficult to leave the situation in the event of developing panic like symptoms
What 5 things do Agoraphobia ppl fear?
using public transportation being in open spaces being in enclosed places standing in line or being in a crowd being outside of the home alone
How many things must be met for DSM-5 criteria for agoraphobia?
> 2
What questionnaire is used for agoraphobia?
The Fear questionnaire
What is the treatment for agoraphobia?
CBT w/ meds
What is 1st line med for agoraphobia?
SSRI, SNRIs, TCA, Benzo
What is the prognosis for agoraphobia?
most pt recover with txt
What are the four types of phobias?
animal
environmental
blood injection/ injury type
situational type
Zoophobia?
animals
Brontophobia
thunderstorms
Acrophobia
heights
Nosophobia
disease
Thanatophobia
death
The most common psychiatric disorder among women?
phobias
What is the predominant age and sex for phobias?
15yr and female
What symptoms seen with exposure to phobic stimuli?
sympathetic activation, pallor, dizziness, or paresthesias
What is the txt for specific phobias?
treat major psychiatric disorders first
What is not a 1st line txt for specific phobia?
medication
Prognosis of specific phobias?
lifelong if untreated, excellent w/ treatment
What is acute stress disorder?
acute stress reactions that may occur in the initial month after a person is exposed to a traumatic event
What makes up the major prevalence of ASD?
witnessing a mass shooting
What are the clinical manifestations of ASD?
presents w/ severe levels of re-experiencing and anxiety in response to reminders of the recent trauma
What is the most effective txt for ASD?
CBT
What drugs haven’t been shown to be effective in ASD?
SSRI
Helpful for acute anxiety, agitation, or sleep disturbance in the immediate period following the traumatic event?
Benzo
What is post-traumatic stress disorder (PTSD)?
intrusive and avoidance symptoms, negative changes in thought or mood, and arousal/reactivity for at least 1 month following a traumatic event
What is the treatment for PTSD?
early CBT, w/ virtual exposure, has been shown to speed recovery
Prognosis for PTSD?
symptoms spontaneously remit after 3 mo
Which med doesn’t work for Agoraphobia?
Bupropion
Which specific phobia has the highest level of familial tendency?
blood injection/ injury type
What are two things that must be recognized in specific phobia?
fear is irrational or excessive or egodystonic
In order to be diagnosed with ASD what criteria must be met?
directly experiencing the traumatic event or related to someone that did!