Case 5 - Anxiety Disorder

Question 1

when does anxiety become abnormal

Answer 1

• excessively intense
• disproportionate to the stimulus
• triggered by harmless situations
• without a cause
• can not be controlled

Question 2

what are anxiety disorders associated with

Answer 2

dysfunction of the amygdala

Question 3

what do phobias relate to

Answer 3

a specific situation

Question 4

what is generalised anxiety disorder

Answer 4

a state of inappropriate and severe anxiety without adequate cause, that lasts for at least 6 months

Question 5

what is GAD characterised by:

Answer 5

• free floating anxiety or apprehension not linked to a specific cause or situation
• excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source off worry

Question 6

who is anxiety most common in

Answer 6

females - 2:1

Question 7

when is common onset age

Answer 7

20s

Question 8

what are the psychological signs and symptoms of anxiety

Answer 8

• constant worries - often intrusive
• pervasive feeling of apprehension or dread
• poor concentration
• frustration and irritability
• inability to tolerate uncertainty

Question 9

what are the physical signs and symptoms of anxiety

Answer 9

• trembling and swearing
• nausea
• hot flashes and headaches
• difficulty swallowing

Question 10

what are the behavioural symptoms of anxiety

Answer 10

• putting things off because you feel overwhelmed
• avoidance e.g leaving home and using public transport
• drug taking to relieve anxiety

Question 11

what is operation diagnosis

Answer 11

a type of psychiatric diagnosis system
- the person must experience a certain number of symptoms
- at least a minimum specified period
- the symptoms must cause: significant disease and be associated with impairment of everyday function

Question 12

what are the two operational diagnostic systems used

Answer 12

5th edition of the diagnosis and statistical manual
10th edition of the International classification of diseases

Question 13

criteria of GAD diagnosis

Answer 13

excessive anxiety or worry about s range of events or activities that is persistent
i.e:
- at least 6 out of 12 diagnostic criteria in ICD-10
- symptoms more than 6 months in DSM-IV
- not restricted to a particular circumstance
- contrast to a phobia
- contrast to OCD

Question 14

what is the assessment for GAD

Answer 14

• full psychiatric history
• collateral history
• exclude physical causes or complicating factors
  e.g hyperthyroidism, angina, asthma, caffeine
• check whether alcohol or drugs is used to self medicate
• asses for depression

Question 15

what is the treatment plan for GAD

Answer 15

1. exclude any underlying medical cause
2. exclude any substance abuse related anxiety
3. short term treatment with benzodiazepines
4. long term treatment with beta blockers/SSRI/SNRI
5. long term treatment with pregabalin

Question 16

what is the link between stroke and the DVLA

Answer 16

the patient must stop driving immediately. it is possible to return to driving as long as it is safe to do so and the correct procedures are followed

if you have a valid driving license, you are not allowed to drive for at least one month after a stroke or a TIA. after a month a patient can start driving again if the doctor is happy with the recovery of the patient

if the patient has had a number of TIA’s over a short period you will need to wait until you have not had any TIA’s for 3 months before returning to driving