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Psychiatry > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

What is psychological stress?

A

An individual’s reaction to stress will depend on a balance between their cognitive processing of any perceived threat and perceived ability to cope
Coping is problem and emotion focussed

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2
Q

How might emotion focussed coping mechanisms for stress be managed?

A

Relaxation training

Sedative

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3
Q

How can symptoms of anxiety be grouped?

A 
Psychological arousal
Autonomic Arousal
Muscle Tension
Hyperventilation
Sleep Disturbance
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4
Q

How are stress and performance linked?

A

Performance is often optimal at medium stress but any extreme levels of stress on either end is associated with sub-optimal performance

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5
Q

How might psychological arousal in anxiety present?

A 
Fearful Anticipation
Irritability
Sensitivity to noise
Poor concentration
Worrying Thoughts
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6
Q

How might autonomic arousal present?

A 
Dry mouth 
Swallowing difficulties
Dyspepsia
Nausea
Loose BMs
Tight chest
Palpitations
Chest pain
Frequency/urgency of micturation
Erectile failure
Dizziness/sweating
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7
Q

How might muscle tension present with anxiety?

A

Tremor
Headache
Muscle pain

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8
Q

How might hyperventilation present with anxiety?

A

CO2 deficit hypocapnia
Numbness/tingling in extremities
SOB

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9
Q

How might sleep disturbance present in anxiety?

A

Initial insomnia
Frequent waking
Nightmares/terrors

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10
Q

What is the difference between generalised and phobic anxiety disorders?

A

Generalised occur persistently whether as Phobic occur in particular circumstances

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11
Q

What are some common phobic anxiety disorders?

A

Agoraphobia
Social phobia
Specific phobias

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12
Q

How might GAD present?

A

All the same symptoms as normal anxiety
Symptoms persist for several months
Not confined to a situation or subject

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13
Q

What are some psychiatric differential diagnose for anxiety disorders?

A

Depression
Schizophrenia
Dementia
Substance Misuse

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14
Q

What are some physical differential diagnoses for anxiety disorders?

A

Thyrotoxicosis
Phaeochromoctoma
Hypoglycaemia
Asthma and or Arrhythmias

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15
Q

Does GAD affect more men or women?

A

Women

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16
Q

What causes GAD in general terms?

A

GAD for instance is caused by a stressor acting on a personality predisposed to the disorder by a combination of genetic factors and environmental influences in childhood

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17
Q

What are some components of counselling for GAD?

A

Clear Plan of Management
Explanation and education
Advice re caffeine, alcohol, exercise etc

18
Q

How does relaxation training work to treat GAD?

A

Group or individual

DVDs, tapes or clinician led

19
Q

What are some medications used to manage GAD?

A

Sedatives
SSRIs
TCAs

20
Q

What is a drawback of sedatives?

A

High risk of dependency

21
Q

How is CBT used for GAD?

A

Emotional response depends on cognitive processing
Identifying errors, reprocessing and reassessing responsibility are key elements
Patients tend to find this intuitively sensible
Maintaining remission appears superior to drug therapy

22
Q

How do phobic anxiety disorders present?

A

Similar to GAD but only in specific circumstances
Person behaves to avoid these circumstances
Also experiences anxiety if there is a perceived threat of encountering the feared object or situation

23
Q

What is a specific phobia?

A

Overwhelming and unreasonable fear of objects or situations that pose little real danger but provoke anxiety and avoidance

24
Q

What is a social phobia?

A

Inappropriate anxiety in situation where person feels observed or could be criticised
E.g. restaurants, shops, public speaking

25
Q

Which anxiety symptoms predominate in social phobias?

A

Blushing

Tremor

26
Q

How might social phobias be managed?

A

CBT
Education and advice
SSRIs

27
Q

What are the core features of OCD?

A

Recurrent obsessional thoughts

Compulsive acts

28
Q

What are obsessional thoughts?

A

Ideas/images/impulses

Unpleasant and distressing, often obscene or violent

29
Q

What is an aetiological theory for OCD?

A

Genetic

5HT receptor genes affected causing abnormal fucntion

30
Q

What are some serotonergic drugs used to treat OCD?

A

SSRIs like fluoxetine

Clomipramine

31
Q

Can CBT be used for OCD?

A

Yes

32
Q

What is PTSD?

A

Delayed and/or protracted reaction to a stressor of exceptional severity

33
Q

What are some common stressors in PTSD?

A 
Combat
Natural or human-caused disaster
Rape
Assault
Torture 
Witnessing any of the above
34
Q

What are the three key elements to reaction in PTSD?

A

Hyperarousal
Re-experiencing phenomena
Avoidance reminders

35
Q

What is hyperarousal?

A

Persistent anxiety
Irritability
Insomnia
Poor concentration

36
Q

What is re-experiencing phenomena?

A

Intense intrusive images
Flashbacks when awake
Nightmares during sleep

37
Q

What is avoidance in PTSD?

A

Emotional numbness
Cue avoidance
Recall difficulties
Diminishes interests

38
Q

Does PTSD affect more men or women?

A

Women 2:1

NB data is from US

39
Q

What are some factors which may mean an individual is vulnerable to ptsd?

A 
Mood disorder
Previous trauma especially as child
Lack of social support 
Female 
Lack of protective factors like higher education, social group or good parental relationship
40
Q

How is severe PTSD treated?

A

CBT

41
Q

What is circumstantiality?

A

Sign of anxiety disorders or hypomania
Over-inclusive speech that is delayed in reaching its final goal
Easy enough to follow and does eventually reach its goal

Psychiatry (18 decks)

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