Anxiety & Obsessive-Compulsive Disorders Flashcards
excessive and persistent worry that is hard to control, causes significant distress or impairment, and occurs more days than not for at least 6 months
generalized anxiety disorder
GAD is often comorbid with _____ and _____ _____ _____
depression
substance use disorders
besides excessive worry, how many other symptoms does an adult present with if they have GAD?
3 or more
besides excessive worry, how many other symptoms does a child present with if they have GAD?
1
if a patient presents with restlessness, easy fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance - what diagnosis should we think of?
generalized anxiety disorder
what screening tool can be used for GAD?
general anxiety disorder 7
along with CBT, what is the first line medication to treat GAD?
SSRI
what is the 2nd line medication to treat GAD?
tricyclic antidepressants
what medications can be used for GAD if the patient has limited or no response to an SSRI and tricyclic antidepressants?
benzodiazepines
uses thought exercises or real experiences to facilitate symptoms reduction and improved functioning
behavioral therapy
GAD usually has a _____ course
chronic
in 40-year follow up, GAD tended to disappear at about age 50 but was replaced by _____ _____ _____
undifferentiated somatization disorder
there is an association between anxiety and mortality in patients with _____ _____
coronary disease
abrupt surge of intense fear, reaching a peak within minutes
panic attack
a patient presents with palpitations, sweating, trembling, SOB sensation, chest pain, nausea, dizziness, derealization, paresthesia, fear of dying and chills/hot flashes. what are they likely experiencing?
panic attack
recurrent unexpected panic attacks and over one month of worry about additional attacks/implications of the attack OR a significant maladaptive change in behavior related to the attacks
panic disorder
what is the treatment for panic attacks and panic disorder?
CBT + medications
what is the 1st line medication for panic attacks and panic disorder?
SSRIs
what are the 2nd line medications for panic attacks and panic disorder? (2)
SNRI
tricyclic antidepressants
what can be used as a medication for panic attacks/panic disorder if SSRIs, SNRIs, and tricyclic antidepressants do not work?
benzodiazepines
what is the rule of thumb for bipolar patients with panic attacks/panic disorder who are taking an SSRI?
go low and slow
which tricyclic antidepressant works best for panic attacks/panic disorder?
tofranil (imipramine)
fear or anxiety about and/or avoidance of situations where help may not be available or where it may be difficult to leave the situation in the event of developing panic-like symptoms or other incapacitating/embarrassing symptoms
agoraphobia
what are 2 medical conditions that may exacerbate agoraphobia?
crohn’s disease
IBS
what can be used to diagnose a patient with agoraphobia?
the fear questionnaire
what is the treatment for agoraphobia?
CBT + medications
what are the 1st line medications for agoraphobia?
SSRIs
SNRIs
tricyclic antidepressants
benzodiazepines
excessive/irrational fear and avoidance of clearly discernible, circumscribed objects and situations
specific phobias
what kind of phobia is associated with a strong vasovagal reaction?
blood-injection / injury phobia
what is the predominant age for specific phobias?
15 years
what is the most common psychiatric disorder among women?
phobias
which type of phobia has a very high familial tendency?
blood-injection / injury phobia
what will a patient with a specific phobia be able to do?
recognize that the fear is completely irrational and/or excessive
a patient presents with irrational or egodystonic fear of a specific situation, activity, or object with associated avoidant behavior. they also have sympathetic activation, pallor, dizziness, and/or paresthesia. what are they likely experiencing?
a specific phobia
what is our first treatment goal for a patient with specific phobias?
treat major psychiatric disorders first
what are the first line treatments for specific phobias? (2)
CBT
exposure-based treatment
what medication, if any at all, can be used to treat specific phobias - even though medications are not the first line?
benzodiazepines
acute stress reactions that may occur in the initial month after a person is exposed to a traumatic event
acute stress disorder
when must acute stress disorder occur after a person is exposed to a traumatic event?
in the same month
what are the top 4 incidences that cause acute stress disorder?
witnessing a mass shooting
assault
motor vehicle accident
mild TBI
a patient presents with severe levels of re-experiencing and anxiety in response to reminders of a recent trauma, and may present with a flat or blunted affect (emotional numbness)
acute stress disorder
what kind of symptoms does a patient with acute stress disorder exhibit?
dissociative symptoms
what is the most effective treatment for acute stress disorder?
CBT that is trauma focused
what medication may be helpful for acute anxiety, agitation, or sleep disturbance for acute stress disorder?
benzodiazepines
between 40-80% of patients with acute stress disorder develop subsequent _____
PTSD
repetitive behaviors or mental acts
compulsions / rituals
repetitive and persistent thoughts, images, or urges
obsessions
what is the treatment for OCD?
CBT
SSRI
TCA
which TCA can be used to treat OCD?
clomipramine
