Anxiety Disorders

Question 1

Tool to use to diagnose for anxiety?

Answer 1

AMPSS tool

Anxiety 
Mood 
Psychosis 
Substance use 
Suicide

Question 2

Tool used for diagnosing depression

Answer 2

DSQ-2/9

Question 3

Anxiety definition

Answer 3

Diffuse, unpleasant, vague sense of apprehension. Often accompanied by autonomic symptoms such as a headache, perspiration, palpitations, restlessness, tightness in the chest and GI distress.

Question 4

Fear vs anxiety

Answer 4

Fear = response to a known external definite threat

Anxiety = response to an unknown internal and vague threat

Question 5

Panic attack strict definition

Answer 5

Abrupt onset of intense fear or discomfort that peaks within minutes.

Includes at least 4 of the following symptoms

• palpitations
• sweating
• short of breath
• chest pain
• dizziness/lightheadedness
• feeling faint
• paresthesia
• fear of losing control
• trembling/shaking
• sensation of choking
• nausea/ab discomfort
• chills or flushing
• overwhelmslming sense of fear/dying/dread

need this one almost every time

Question 6

Algophobia

Answer 6

Fear of pain

Question 7

Trypanophobia

Answer 7

Fear of needles/injections

Question 8

Agoraphobia

Answer 8

Fear of facing/anticipating at least 2 specific situations usually dealing with open,public spaces. Must last at least 6 months

• feel “stuck or unable to escape”
• often leads to someone staying in their home (this is not diagnostic though)

Question 9

Epidemiology of anxiety

Answer 9

25% of patients with comorbidity are to have anxiety

Women have anxiety more than men

• however both sexes get treated on average the same amount
• women are more likely to remain quiet

42 billion dollars a year are spent on health care costs and lost of productivity associated with anxiety

50% of patients who are “recovered” often experience recurrence and failure to go into remission.

Question 10

Glossophobia

Answer 10

Fear of public speaking

Question 11

Ophidiophobia

Answer 11

Fear of snakes

Question 12

What is the timeline required for almost all anxiety disorders?

Answer 12

> 6 months

Question 13

Social anxiety disorder

Social phobia/pathological shyness

Answer 13

Exaggerated fear of embarrassment in social situations for at least 6 months
includes:
- public speaking
- public/social performances
- fear of basically any social situations

Onset is usually in teenage years but can present at any age

Treatment methods:

• CBT and SSRIs
• Venlafaxine is 2nd line
• use BBs and Benzos (small doses) as needed if the disorder is performance-based

often presents with panic attacks as well

any symptoms they have are out of proportion to the actual threat

if not treated, often leads to MDD

Question 14

Nosocomephobia

Answer 14

Fear of hospitals

Question 15

Coulrophobia

Answer 15

Fear of clowns

Question 16

Iatrophobia

Answer 16

Fear of doctors

Question 17

3 components of pain

Answer 17

Psychological

Neuroleptic

Visceral and somatic

Question 18

What is the screening tool sensitive to GAD diagnosis?

Answer 18

GAD-7

Question 19

Panic disorder epidemiology

Answer 19

Women are 3x more likely than men to be affected

Onset is typically young adulthood (25 is mean)

Divorce or Seperation with partner increases odds of this (only social factor known to be linked)

Is often also seen in conjunction with comorbid diagnosis and other mental health disorders

Initial panic attack is usually idiopathic

Question 20

DSM-5 criteria of panic disorder

Answer 20

Recurrent unexpected panic attacks followed by at least 1 month of one or both of the following:

• persistent concern about having additional panic attacks or consequences of having panic attacks
• maladaptive change in behavior in response to the panic attacks

Question 21

How is GAD different from panic disorder?

Answer 21

There is NO spontaneous panic attacks in GAD

Question 22

DSM-5 criteria for GAD

Answer 22

Greater than 6 months of excessive worrying about various aspects of daily life on a near daily basis.
Associated with at least 3 of the following (in children need at least 1) 
- restlessness
- irritability 
- sleep disturbances 
- fatigue 
- muscle tension 
- difficulty concentrating

Question 23

Medical conditions associated with anxiety-like symptoms

Answer 23

Cardiovascular: CAD/CHF/PE/MVP/HTN emergencies

Pulmonary: pneumonia/asthma/COPD

Endocrine: thyroid dysfunction, hyperparathyroidism, hypoglycemia, menopause, cushings disease, pheochromocytoma

Hematologic: anemia

Neurologic: seizures, encephalopathies

Substance abuse disorders

Question 24

Treatment of anxiety disorders

Answer 24

Nonpharmacologic first:

• build relationship with patient
• address other conditions
• CBT

Pharmacological second:

• SSRIs
• venlafaxine
• benzos and BBs (performance anxiety only)

Goal of maintenance therapy
- 6 months - 1 year of treatment