Depression & Anxiety

Question 1

What is the prevalence of anxiety and affective disorders?

What is crossover

Answer 1

Anxiety Ds: most common psych disorder 12.8%
Affective: second most common 6.2%
85% patients with MDD have sig anxiety sx, commorbid depression in 90% patients with AD

Question 2

What is the criteria for MDD?

Answer 2

Five or more nearly every day for 2 weeks (need both 1 and 2)

1. Depressed mood most of day
2. Diminished interest/pleasure
3. Weight
4. Insomnia/hypersomnia
5. Psychomotor agitation/retardation
6. Fatigue
7. Worthlessness/guilt
8. Concentration/indecisiveness
9. Recurrent thoughts of death

Question 3

What does CBT for depression involve?

Answer 3

1. Psychoeducation (model, collab case formulation)
2. behavioural activation (monitoring, scheduling activity)
3. Cognitive restructuring (Identify auto thoughts-> maladaptive core belief-> realistic alt, thought record, behavioural experiments)

Question 4

What are some clinical challenges of depression?

Answer 4

Helplessness and pessimism (depressed learning history)
Excessive standards and vague planning for behavioural activation
Careful not to invalidate with cog challenging

Question 5

What is the criteria for panic disorder?

Answer 5

A. Recurrent, unexpected panic attacks
B. At least one is followed by persistent concern about additional attacks and/or sig maladaptive changes
C. Not effect of phys/substance
D. Not better explained

Question 6

What is the criteria for Generalised Anxiety Disorder?

Answer 6

A. excessive anxiety and worry, more days than not for at least 6 months
B. Difficult to control
C. Assoc with 3 + following sx (restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance)

Question 7

What are the recommended treatments for; panic, social A in adults, social A in children, GAD in adults?

Answer 7

Panic: CBT focus on exposure
SA adults: CBT focus exposure
SA children: CBT
GAD: CBT

Question 8

What are common factors among anxiety disorders?

Answer 8

• maladaptive beliefs
• selective attention/biases
• fear response
• avoidance/safety behaviours

Question 9

What does CBT for anxiety involve?

Answer 9

1. Psychoeducation (normalising & collab case formulation)
2. behavioural strategies (exposure- safety behaviours, heirarchy, experiments- form habituation)
3. Cognitive strategies
4. Relaxation (diaphragmatic breathing)

Question 10

What are some clinical challenges for anxiety?

Answer 10

• self-fulfilling prophecy
• safety behaviours unique
• medication
• therapist anxiety and neg beliefs about exposure