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Psychiatry > Anxiety disorders: Intro & GAD > Flashcards

Anxiety disorders: Intro & GAD Flashcards

1
Q

Define Neurosis

A

Psychiatric Disorders characterised by distress
Non Organic with discrete onset
Delusions and Hallucinations are absent

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2
Q

Define Anxiety

A

Unpleasant Emotional State of subjective fear and somatic symptoms

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3
Q

Define the Yerkes Dodson Law

A

anxiety can actually be beneficial up to a plateau of optimal functioning. beyond this level of anxiety however, performance deteriorates

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4
Q

Name the ICD10 classifications of Anxiety Disorders

A

1 - Phobic related disorders

2 - Other Anxiety Disorders (Panic, GAD)

3 - OCD

4 - Reaction to severe stress and adjustment disorder

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5
Q

Name physical symptoms of Anxiety

A

CVS - Palpitations, chest pain

Resp - Chest Tightness, cough, hyperventilation

GI - Loose Stools, abdominal pain, nausea and vomiting, dysphagia, dry mouth

GU - Increased Micturition Frequency, failure of erection, menstrual discomfort

Neuromuscular - Tremor, myalgia, headache, paraesthesia, tinnitus

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6
Q

Give 5 psychological symptoms of Anxiety

A
  • Impending doom
  • Restlessness
  • Poor Concentration
  • Derealisation
  • Depersonalisation
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7
Q

Anxiety can be Paroxysmal or Continuous. Describe Paroxysmal Anxiety.

A

Situation Dependent - Phobic Anxiety
Situation Independent - Panic Disorder

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8
Q

Anxiety can be Paroxysmal or Continuous. Describe Continuous Anxiety.

A

GAD

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9
Q

Give 5 conditions related to Anxiety

A
  • Hyperthyroid
  • Phaeochromocytoma
  • Cushings
  • Eating Disorders
  • Schizophrenia
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10
Q

Define Generalised Anxiety Disorder

A

Syndrome of ongoing, uncontrollable widespread worry about many thoughts or events that the patient recognised as excessive and inappropriate.
Symptoms present most days for at least 6 months

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11
Q

Describe the genetic aetiology of Anxiety

A

5 fold increase if GAD in first degree relative

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12
Q

Describe the neurophysiological causes of GAD

A

Autonomic Nervous System Dysfunction
Exaggerated activity of Amygdala and Hippocampus
Alterations of GABA/NA/Serotonin

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13
Q

Describe some social risk factors for GAD

A

Divorced
Single Parent
Low Socioeconomic Status
Domestic Violence

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14
Q

The clinical features of GAD can be remembered by the mnemonic ‘WATCHERS’. Define it

A

Worry (excessive, uncontrollable)

Autonomic hyperactivity

Tension in muscles

Concentration difficulty

Headache

Energy Loss

Restlessness

Startled easily

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15
Q

Describe the ICD10 diagnostic criteria for GAD

A

A - Period of at least 6 months of prominent tension, worry, feeling of apprehension
B - Four of the physical symptoms with atleast one being excess autonomic arousal

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16
Q

Describe the expected Appearance, Speech and Mood for a patient with GAD (MSE)

A

Appearance - worried face with burrowed brow, sweaty
Speech - trembling, slow rate
Mood - Anxious

17
Q

Describe the expected Thought, Perception, Cognition and Insight for a patient with GAD (MSE)

A

Thought - Repetitive worrying thoughts
Perception - No Hallucinations
Cognition - Poor memory and reduced concentration
Insight - May or may not have insight

18
Q

what are some differentials for GAD

A

other neurotic disorders - panic disorder, specific phobias, OCD, PTSD

depression

schizophrenia

personality disorder

excess caffeine or alcohol

withdrawal from drugs

organic - anaemia, hyperthyroidism, phaeochromocytoma, hypoglycaemia

19
Q

Name 3 Questionnaires used for GAD

A
  • GAD7
  • Becks Depression Inventory
  • Hospital anxiety and depression scale
20
Q

What is the first line management for GAD?

A

Low Intensity Psychological interventions such as Psychoeducational Groups

21
Q

What is the Second Line management for GAD?

A

Combination of CBT and SSRI (Sertraline - continued for at least a year)

22
Q

Name three other medications that can be used for GAD

A

SNRIs - Venlafaxine or duloxetine
Pregabalin
Benzodiazepines (Short Term)

23
Q

Name three social interventions for Generalised Anxiety Disorder

A

Self Help Methods
Support Groups
Exercise Encouragement

24
Q

predisposing risk factors for GAD

A

genetics

childhood upbringing

personality type and demands for high achievement

divorced

living alone or as a single parent

low socioeconomic status

25
Q

precipitating risk factors for GAD

A

stressful life events - domestic violence, unemployment, relationship problems, personal illness

26
Q

maintaining risk factors for GAD

A

continuing stressful events

marital status

living alone

27
Q

symptoms of GAD overview

28
Q

what blood tests might you want to do in someone who has anxiety?

A

FBC - anaemia/infection

TFTs - hyperthyroidism

glucose - hypoglycaemia

29
Q

stepwise approach to managing GAD

Psychiatry (18 decks)

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