Anxiety Disorders Flashcards
What is anxiety?
Defined as 6 months of excessive worry about different events with a sense of heightened tension
What are the risk factors of Generalised Anxiety Disorder?
- Gender (female)
- Family history of anxiety
- Physical or emotional stress
- History of physical or emotional trauma
- Other anxiety disorders
What are the causes of Generalised Anxiety Disorder?
- Genetic predisposition
- Stress
- Life events
- Hyperthyroidism
- Cardiac disease
- Medication induced anxiety
What are the medications that may induce anxiety?
- Salbutamol
- Corticosteroids
- Theophylline
- Antidepressants
- Caffeine
What are the clinical features of Generalised Anxiety Disorder?
- Hyperventilation (may present as respiratory alkalosis on ABG)
- Headaches, nausea
- Sweating
- Palpitations
- Poor concentration
- Tension
- Agitation
- Insomnia
- Restlessness
=> Psychological symptoms can manifest as digestive problems
What is the DSM-5 criteria for diagnosis Generalised Anxiety Disorder?
- Excessive anxiety present more days than not for 6 months
- Hard to control anxiety
- Adult - > 3 symptoms present
- Anxiety causes impairment in important daily activities
- Symptoms not linked to medication, drug abuse or condition
- Anxiety not better explained by another medical condition
What is the management of Generalised Anxiety Disorder?
=> Stepwise approach
- Educate on GAD and active monitoring
- Low intensity psychological intervention
- High intensity psychological intervention or drugs
- Special input
=> Drug treatment:
- First line SSRI => Sertraline
What are panic disorders?
Intense fear something bad will happen
More common is females
What are the symptoms of panic disorders?
Symptoms peak in first 12-20 mins and may last for hours
- Fear of death
- Fear of losing control
- Feelings of detachment
- Feeling of choking
- Dizziness
- Dyspnoea
- Nausea
- Sweating
- Chills
- Palpitations
- Chest pain
- Numbness
- Trembling
What is the DSM-5 criteria for diagnosing panic disorders?
- At least 4 of 13 symptoms must be present
- Recurrent, unexpected panic attacks
- Persistent worry and change in behaviour
- Not effects of substance
- Not explained by another disorder
What is the management of panic disorders?
=> Involves psychotherapy (CBT), medication or both
=> Steps of CBT:
- Learn
- Monitor
- Breathing and relaxing exercises
- Change beliefs about severity of attack
- Allow exposure to possible triggers
=> Medication:
- SSRIs first line (if contraindicated or no response in 12 weeks - Imipramine or Clomipramine
- Benzodiazapines
- Anti-seizure medications
What are the 2 main features of OCD?
Obsessions - unwanted recurrent, intrusive thoughts which may cause anxiety
Compulsions - actions to reduce anxiety from obsessions impact daily life
What is the DSM-5 criteria for diagnosing OCD?
- Presence of obsessions, compulsions or both
- Compulsion is time consuming
- Not due to substance o medical condition
- Not better explained by another disorder
What are the causes of OCD?
- Genetic or environmental
- More common in identical twins
- Problems wit serotonin transmission
What is the management of OCD?
CBT or medication (SSRIs)
