Anxiety Disorders- Presentation, Diagnosis, Symptoms

Question 1

GAD definition

Answer 1

excessive, difficult to control anxiety and worry about multiple events or activities; symptoms of restlessness/feeling on edge or muscle tension

Question 2

GAD diagnostic criteria

Answer 2

Persistent symptoms for most days for at least 6 months. It’s unrealistic or excessive about a number of events or activities

Accompanied by at least 3 physiologic or psychological symptoms

Question 3

Psychological symptoms of GAD

Answer 3

excessive anxiety, worries that are difficult to control, feeling on edge, poor concentration or mind going blank

Question 4

Physical symptoms of GAD

Answer 4

restlessness, fatigue, muscle tension, sleep disturbances, irritability

Question 5

Impairment in GAD

Answer 5

socially, occupationally, poor coping skills

Question 6

Medical illnesses and GAD

Answer 6

a lot of the diseases (the ones in the chart) are chronic, lifelong diseases and patients may feel anxiety about having these diseases, treating them, living with them, etc.

Question 7

Anxiety syndromes

Answer 7

anxiety could be the presenting symptom of mood disorders, schizophrenia, delirium, dementia, substance abuse

Question 8

Drug-induced anxiety syndromes causes

Answer 8

AEDs, ADs, antihypertensives, ABX, bronchodilators, corticosteroids, DAs, herbal agents, illegal drugs, stimulants, toxicity, withdrawal

Question 9

PAD Definition

Answer 9

recurrent unexpected panic attacks, in absence of triggers; persistent concern about additional panic attacks and/or maladaptive change in behavior related to attacks for at least 1 month

Question 10

PAD diagnostic criteria

Answer 10

Patient has ≥4 symptoms (psychological and physical)

Question 11

How long do panic attacks last?

Answer 11

Attacks last 20-30 minutes, the first 10 minutes are the WORST

Question 12

Psychological symptoms of PAD

Answer 12

fear of losing control, going crazy, dying, depersonalization, derealization

Question 13

Physical symptoms of PAD

Answer 13

abdominal distress/nausea, chest pain/discomfort, chills/hot flashes, dizziness, palpitations/tachycardia, SOB, trembling/shaking, sweating

Question 14

Agoraphobia definition

Answer 14

anxiety about being in at least 2 different situations or places where escape is difficult or help’s not available, develops in 50% of patients secondary to a panic attack but panic attacks may never be experienced

Question 15

Specific phobias definition

Answer 15

persistent fear of object or situation and the patient is free of symptoms (symptoms aren’t there despite being around panic-stimulus)

Question 16

SAD definition

Answer 16

marked, excessive, unreasonable fear or anxiety about social situations in which there may be scrutiny by others, which is actively avoided

Question 17

Principal physical indicator and distinguishing feature of SAD

Answer 17

Blushing

Question 18

Common situations where SAD could be triggered

Answer 18

addressing a group of people, eating or writing in front of others, interacting with authority, public speaking, talking to strangers, use of public facilities

Question 19

Distinguishing feature of SAD vs. PAD

Answer 19

SAD is the fear of being embarrassed

PAD is the fear of having anxiety

Question 20

PTSD diagnostic criteria

Answer 20

Exposure to traumatic event is required that must include threatened death or serious injury- possible harm to self or others

Response to event must include intense horror, fear, or feelings of helplessness

Patients must have at least 1 intrusion symptom, 1 avoidance symptom, and at least 2 symptoms of each negative alterations in cognition and mood and symptoms of increased arousal; symptoms must be present >1 month and cause significant distress or impairment in functioning

Question 21

PTSD intrusion symptoms

Answer 21

recurrent, intrusive distressing memories of the trauma; recurrent, disturbing dreams of the event, dissociative flashbacks and feeling like the trauma event is recurring, physiologic reaction to or psychological distress from reminders of the trauma

Question 22

PTSD symptoms: negative alterations in thinking and mood

Answer 22

inability to recall an important aspect of the trauma, anhedonia, estrangement, restricted affect, negative beliefs about oneself, distorted beliefs causing one to blame others or themselves for the trauma, negative mood state

Question 23

PTSD avoidance symptoms

Answer 23

avoiding convos, thoughts, or feelings about the event, avoiding people, places, or activities that are reminders of the event

Question 24

PTSD specifiers

Answer 24

dissociative symptoms, depersonalization or derealization, with delayed expression: full criteria aren’t met until at least 6 months post-trauma

Question 25

PTSD hyperarousal symptoms

Answer 25

decreased concentration, easily startled, hypervigilance, sleep disorders/insomnia, agitation, irritability, outbursts, self-destructive behavior

Question 26

OCD: obsession

Answer 26

persistent, recurrent idea, thought-impulse that is intrusive and inappropriate and produces marked anxiety

Question 27

OCD: compulsion

Answer 27

repetitive behavior or mental act performed in response to an obsession