Anxiety Disorders; Trauma and Stress Related Disorders Flashcards

1
Q

What is generalized anxiety disorder?

A

excessive anxiety and worry occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance)
-the individual finds it difficult to control the worry

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2
Q

What are the symptoms of anxiety?

A

the anxiety is associated with three (or more) of the following six symptoms

  • restlessness or feeling keyed up or on edge
  • being easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
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3
Q

What are the characteristics of generalized anxiety?

A
  • the anxiety causes clinically significant distress or impairment
  • the disturbance is not attributable to the physiological effects of a substance or another medical condition
  • the disturbance is not better explained by another mental disorder
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4
Q

What is the tx of generalized anxiety disorder?

A
  • SSRIs: paroxetine and escitalopram; SNRIs: Venlafaxine
  • Buspirone is also effective; the starting dose is 5 mg PO bid or tid, however, buspirone can take at least 2 week before it begins to help
  • Benzodiazepines (short-term use), beta blockers
  • Psychotherapy
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5
Q

What is panic disorder?

A

an occurrence of three panic attack (sudden unexpected periods of intense fear or discomfort) episodes in three weeks

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6
Q

What are the characteristics of panic disorder?

A
  • at least one of the attacks has been followed by one month (or more) of one or both of the following
  • persistent concern or worry about additional panic attacks or their consequences
  • a significant maladaptive change in behavior related to the attacks
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7
Q

What is the tx of panic disorder?

A
  • SSRIs: Paroxetine, sertraline, fluoxetine
  • Benzodiazepines: for acute attacks (watch for abuse)
  • CBT (relaxation, desensitization, examining behavior consequences)
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8
Q

What is social phobia?

A

social anxiety disorder

  • marked and persistence (> 6 months) fear of social or performance situations in which one is exposed to unfamiliar people to possible scrutiny by others
  • fear of acting in a humiliating or embarrassing way
  • public speaking, initiating conversation, dating, eating in public
  • may coexist with avoidant personality disorder
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9
Q

What is specific phobias?

A

excessive and persistent fear of a specific object, situation or activity that is generally not harmful

  • lasts for 6 months or more
  • patients know their fear is excessive, but they can’t overcome it
  • these fears cause such distress that some people go to extreme lengths to avoid what they fear
  • examples are fear of flying or fear of spiders
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10
Q

What is the tx specific phobias?

A

treat with exposure therapy (first line), teach to relax and try to understand/overcome the fear

  • SSRI + CBT
  • benzodiazepines (i.e. prior to flying)
  • treat agoraphobia just as GAD with SSRIs and CBT
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11
Q

What is post-traumatic stress disorder?

A

the patient has experiences a traumatic event which causes an acute stress reactions
-once the symptoms persist past 1 month it is now considered post-traumatic stress disorder

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12
Q

What is the tx for PTSD?

A
  • SSRIs are first-line
  • Cognitive Behavioral Therapy (CBT)
  • Prazosin for nightmares
  • Benzodiazepines, if used, should not be continued more than 2 weeks after a traumatic event
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13
Q

What is adjustment disorders?

A

the disproportionate response to a stressor that would normally be expected (job loss, physical illness) which begin within 3 months of stressor and end within 6 months after stressor resolved
-reaction out of proportion to the stressor or impairs daily functioning

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14
Q

What are the stresses that cause adjustment disorders

A
  • marital conflict
  • financial conflict
  • family conflict/parental separation
  • school problems/changing schools
  • sexuality issues
  • death/illness in the family
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15
Q

What is the tx of adjustment disorders?

A

psychotherapy

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