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Psych clerkship > Anxiety et al > Flashcards

Anxiety et al Flashcards

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1
Q

What is the best psychotherapy for OCD?

A

Behavioral therapy involving exposure and response prevention

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2
Q

What is the best pharmacotherapy for OCD?

A

SSRI (fluoxetine, sertraline, and fluvoxamine) => adolescents
- Clomipramine => adolescents

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3
Q

What is the lifetime prevalence of OCD?

A

2-3%; accounts for 10% of outpatient psychiatric clinic visits

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4
Q

What is the mean age of presentation of OCD?

A

20yo with male adolescents being more affected than female (but same in adult population)

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5
Q

What is PANDAS?

A

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections => group of disorders including OCD, that have been demonstrated to occur after streptococcal infection

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6
Q

Which disorders are associated with OCD?

A
  • MDD
  • Social phobia
  • Generalized anxiety disorder
  • Alcohol use disorders
  • Specific phobias
  • Panic disorders
  • Eating disorders
  • Tics and Tourette’s
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7
Q

What neurotransmitter imbalances are seen in anxiety?

A
  • Increased norepinephrine

- Decreased GABA and serotonin

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8
Q

What are medical causes of anxiety disorders?

A
  • Hyperthyroidism
  • Vitamin B12 deficiency
  • Hypoxia
  • Neurological disorders (epilepsy, brain tumors, multiple sclerosis cerebrovascular disease)
  • Cardiovascular disease
  • Anemia
  • Pheochromocytoma
  • Hypoglycemia
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9
Q

What are medication/substance induced anxiety disorders?

A
  • Caffeine intake/withdrawal
  • Amphetamines
  • Alcohol and sedative withdrawal
  • Mercury or arsenic toxicity
  • Organophosphate or benzene toxicity
  • Penicillin/ Sulfonamides
  • Sympathomimetics
  • Antidepressants
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10
Q

What is the minimum criteria for a panic disorder?

A

At least one attack with at least one month of the following:

  • persistent concern about having additional attacks
  • worry about the implication of the attack (losing control or “going crazy”)
  • a significant change in behavior related to the attacks
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11
Q

What neurotransmitter differences are seen in anxiety disorders?

A
  • increase norepinephrine

- decrease serotonin and GABA

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12
Q

What is the best treatment for anxiety disorders?

A

SSRI (especially paroxetine and sertraline)
- use higher doses than for depression
Benzodiazepines are only for immediate relief

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13
Q

What proportion of patients with a phobic disorder also has major depression?

A

one third

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14
Q

How is performance anxiety successfully treated?

A

Beta blockers

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15
Q

What is systemic desensitization?

A

Systemic desensitization is the gradual exposure of a patient to the feared object or situation while teaching relaxation and breathing techniques

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16
Q

What is the flooding technique in treating anxiety?

A

Flooding is confronting the patient with their full fear

17
Q

What is the most effective therapy for specific phobias?

A

Behavioral therapy is most effective and systemic desensitization is often used
- pharmacological treatment has not been found effective

18
Q

What is the treatment for social anxiety?

A

Paroxetine (SSRI)

19
Q

What is the difference between an obsession and a compulsion?

A

Obsession => recurrent and intrusive thought, feeling, or idea that is egodystonic. Often suppressed and are a product of the patient’s own mind

Compulsion => a conscious repetitive behavior linked to the obsession that helps to relieve anxiety caused by the obsession

20
Q

What psychiatric conditions are often co-morbid with OCD?

A
  • OCD, Tourette’s and ADHD are frequently co-morbid
21
Q

What neurotransmitter abnormality is associated with OCD?

A

Abnormal regulation of serotonin

22
Q

What is the treatment for OCD?

A
  • SSRIs are first line (doses are higher than “normal”)
  • Clomipramine is also effective
  • ECT or cingulotomy is the last resort
23
Q

What are the criteria for PTSD?

A
  • Presence of a traumatic experience
  • Persistent avoidance
  • Hyperarousal
  • Re-experiencing the traumatic event
  • for at least one month
24
Q

What is the treatment for PTSD?

A
  • SSRIs
  • TCAs ( imipramine, doxepin)
  • MAOIs
  • Anticonvulsants for flashbacks and nightmakres
25
Q

What is the difference between PTSD and acute stress disorder?

A
  • PTSD => event occurred at any time in the past AND symptoms last more than one month
  • Acute stress disorder => event occurred less than a month ago AND symptoms last less than a month
26
Q

What are the criteria for generalized anxiety disorder?

A
  • Excessive anxiety and worry about daily events and activities for at least 6 months, for most days of the week
  • Associated with at least 3 of the following: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance
27
Q

What is the treatment for GAD?

A
  • Pharmacotherapy: SSRIs, buspirone, venlafaxine, benzodiazepines (clonazepam, diazepam)
  • Psychotherapy

Psych clerkship (13 decks)

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