Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry > Anxiety Disorders and OCD > Flashcards

Anxiety Disorders and OCD Flashcards

1
Q

General Treatment Principles

A
  1. Decide on diagnosis / diagnoses (may co-exist with other mood/anxiety disorder)
  2. Decide on special investigations
  3. Do a risk assessment (harm to self / others / property)
  4. Decide on where to treat (in-pt, out-pt with/without supervision)
  5. Decide whom to involve (family, friend, work etc)
  6. Decide whom to refer to (psychiatrist, psychologist, social worker etc)
  7. Decide when to follow up and how frequently
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Generalized Anxiety Disorder

A

Chronic excessive worrying

  • accompanied by psychological and physiological Sx of anxiety
  • functioning is impaired
  • anxiety is significantly distressing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

GAD Rx

A

(May only improve in 6-8w - longer than for depressive disorders)

Biological:
-SSRI: Citalopram 20-50mg/d OR Fluoxetine 20-60mg/d
OR
-Benzo: Lorazepam 0,5-2mg tds (response within days, but may be habit forming + other SE)

Psychosocial: CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anxiety definition

A

An unpleasant feeling state in anticipation of future threat

Abnormal anxiety:

  • excessive duration
  • destructive
  • effect on functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stressor definition

A

An event/situation that requires adjustment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Panic attack

A
  • A surge of intense fear or discomfort
  • Peaks in minutes
  • Accompanied by physical and psychological Sx of intense anxiety / intense autonomic arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Panic Disorder

A

Recurrent, UNEXPECTED panic attacks

-continuous worrying about attacks OR dysfunctional behavior due to attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Panic Disorder Rx

A

Biological
-SSRI: Citalopram 20-50mg/d OR Fluoxetine 20-60mg/d
(Continue for 12mo symptom free, then reduce)
OR
-Benzo if quick response needed - Lorazepam 0,5-2mg tds

2nd line
-TCA: only imipramine or clomipramine

Psychosocial
-CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Phobic Disorders

A

Excessive, persistent (6mo +) and unreasonable fear for a circumscribed stimulus, where stimulus is:

  • avoided
  • endured with much anxious distress
  • functioning is impaired and there is clinically significant distress

Social anxiety disorder (social phobia)
Agoraphobia
Specific phobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Social Anxiety Disorder (aka social phobia)

A

Fear/ anxiety about:

  • social situations
  • where exposed to possible scrutiny
  • about showing anxiety symptoms that will be negatively evaluated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Agoraphobia

A

Fear/anxiety about 2+ of:

  • using public transport
  • being in open spaces
  • being in enclosed spaces
  • standing in line or being in a crowd
  • being outside the house alone

Fears/avoids situations because of thoughts that:

  • escape may be difficult
  • help may not be available if panic like or embarrassing symptoms develop (falling/incontinence)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Specific Phobias

A
  1. Animal type: any animal or insect
  2. Natural environment type: heights, thunder etc
  3. Blood-injection-injury type: often ass.w. fainting
  4. Situational type: public transport, lifts etc
    Other type
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Substance induced anxiety disorder

A

-panic attacks or anxiety predominate

Specifiers:

  • with onset during intoxication
  • with onset during withdrawal
  • with onset after medication exposure

(Caffeine, thyroxine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anxiety disorder due to another medical condition

A
  • panic attacks / anxiety predominate
  • evidence of direct effect from another medical condition where condition is a known culprit

(Hyperthyroidism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Discontinuing medication in anxiety disorders

A 
1yr of complete remission
Full functioning restored
Patient has sense of well-being
Do it slowly over months
Re-instate Rx lifelong if relapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anxiety Disorders in children

A

Separation anxiety disorder
Generalized anxiety disorder
Social anxiety disorder

17
Q

Normal separation anxiety

A
  • universal child awareness of separation from mother / primary caregiver
  • peaks between 9-18mo, diminished by 2 and a half years
18
Q

Separation anxiety disorder

A

-inappropriate & excessive anxiety when faced with separation from major attachment figure

Characteristic physiological traits: higher morning cortisol, higher average resting HR, low HR variability

19
Q

Generalized anxiety disorder (paeds)

A
  • significant distress in daily activities (fears incompetence in school performance, or in social settings (>4w)
  • Sx of autonomic hyperarousal (sweating, nausea, tachycardia, SOB)

+ at least one:

  • restlessness
  • easily fatigued
  • mind going blank
  • irritability
  • muscle tension
  • sleep disturbance
20
Q

Social anxiety disorder

A

-discomfort and distress in social situations - impaired by fear of scrutiny or humilitation

Distress expressed in form of crying, tantrums, avoidance, freezing, or becoming “mute”

  • must experience anxiety in presence of peers, not only adults
  • may exhibit performance type-like fear of public speaking.
21
Q

Paeds anxiety Rx

A

CBT - first line
SSRI’s safe and effective (fluoxetine, citalopram)

Caution with tricyclic anti-depressants - increased risk of suicidal ideations

Use diphenhydramine for sleep disturbances

22
Q

Obsession definition

A

Recurrent, persistent, intrusive, unwanted and distressing thoughts, urges or images.

23
Q

Compulsion definition

A

Repetitive behaviors or mental acts that a person feels driven to do in response to an obsession or according to rigidly applied rules

  • aimed at preventing/reducing anxiety or distress, or preventing something dreaded
  • either unrealistic or excessive
24
Q

Obsessive Compulsive Disorder

A

Related behaviors: avoidance, time consuming, injury or damage

Specifiers:

  • with good/fair insight
  • with poor insight
  • with absent insight / delusional beliefs
25
Q

OCD Mx

A
  1. Risk Assessment
  2. Psychoeducation
  3. Biological Rx
    - SSRI (1st line)
    - TAD: Clomipramine (later line)
  4. Psychosocial Rx
    - CBT and BT (behavioural therapy)
  5. Decice whom to involve and whom to refer to
26
Q

Body Dysmorphic Disorder

A

Preoccupied with exaggerated perceived flaws in physical appearance leading to repetitive behaviors or mental acts

  • causes marked distress OR impairs functioning
  • not better explained by an eating disorder

Specifiers:

  • good/fair insight
  • poor insight
  • absent insight / delusional beliefs

About being too small or not muscular enough: with muscle dysmorphia

27
Q

Body Dysmorphic Disorder Mx

A
  1. Risk assessment (comorbid disorders, unecessary surgery)
  2. Psychoeducation
  3. Biological Rx
    - SSRI. Some evidence, but still a good start - fluoxetine
  4. Psychosocial Rx
    - CBT and BT
  5. Whom to involve and whom to refer to
28
Q

Hoarding Disorder

A

Persistent difficulty parting with possessions

-marked distress or impaired functioning

29
Q

Hoarding Diff Dx

A

Can be a symptom of:

  • a psychotic disorder
  • OCD
  • MDD
  • neurocognitive disorder (alzheimers, brain trauma, post-encephalitis)
  • intellectual disability
  • autistic disorder
30
Q

Hoarding Rx

A

Not very valuable: try SSRI, CBT and BT

31
Q

Trichotillomania

A

Recurrent, irresistible urges to pull out body hair

32
Q

Trichobezoar

A

A mass found in the digestive system (hairball)

33
Q

Dermatotillomania

A

Aka excoriation disorder

-chronic skin picking, touching, scratching, digging

Psychiatry (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions