Anxiety disorders

Question 1

Mx of GAD

Answer 1

• psychoeducation and active monitoring
• no response: low intensity interventions (self help, groups, etc.)
• no response OR marked functional impairment: high intensity psychological therapy (CBT or applied relaxation) OR SSRI
• alternative of high intensity/SSRI
• alternative drugs/combination of CBT + SSRI

Question 2

Mx of OCD

Answer 2

• mild functional impairment: low intensity (e.g. brief CBT, group CBT) including ERP
• moderate functional impairment or no response: SSRI or CBT
• severe functional impairment: SSRI + CBT
• no response: alternative SSRI or clomipramine (TCA)

Question 3

Mx of PTSD

Answer 3

• active monitoring if subthreshold/presenting within 1m
• individual trauma-focussed CBT or EMDR
• 2nd line: drug Mx in combination with above or alone: SSRI or venlafaxine; TCAs/mirtazapine/MAOi; APs if refractory and disabling