E2: Anxiety Disorders Flashcards
What are the general etiologies of anxiety disorders?
- Hereditary components (serotonin, noradrenergic systems, glutamate and GABA alternations)
- Environment
- Temperament
What is the treatment of anxiety disorders?
- All involve combinations of therapy and medications
- Can be manages in primary care or psychiatry
What is GAD?
- common disorder in which people worry about many aspects of life
- often co-occurring with other mental disorders and with somatic complaints
What is the criteria to be diagnosed with GAD?
- 6 months with prominent tension, worry, and apprehension
- Difficulty controlling systems
- at least 3: restlessness, easy fatigue, poor concentration, irritability, muscle tension, and sleep disturbance
- causes significant distress
- does not meet criteria for another disorders and not due to a general medical condition
What is the screening tool for GAD?
GAD-7
What is the recommended treatment of mild GAD?
-CBT
What is the treatment of moderate/severe GAD?
- CBT plus medications
- antidepressants: SSRI/SNRI, TCA
- Anxiolytics: Buspirone, hydroxyzine if concerned about Substance abuse. Benzos short term
- Atypicals: Seroquel
What is social anxiety disorder?
- Marked and persistent fear of social or performance situations where person exposed to unfamiliar people or to possible scrutiny by others
- fears that they will act in a way that is embarrassing
What is the treatment for social anxiety disorder?
- CBT
- Possible SSRI/SNRI
- If performance anxiety: beta blocker or short term benzo
What is the etiology of panic disorder?
- Genetic factors: 5 fold increase among first degree relatives, native Americans
- Environmental: triggers, uncontrollable life stressors
What is the criteria to have a diagnosis of panic disorder?
-Discrete period of intense fear or discomfort, in which four or more of the following symptoms develops abruptly and reached a peak within 10 minutes:
Palpitations, sweating, trembling, SOB, chest pain, nausea, dizziness, derealization, fear of dying, fear of losing control, paresthesias, or chills
What is the treatment of panic disorder?
- CBT
- SSRI/SNRI
- Benzos PRN
What is the treatment of specific phobias?
- CBT: Short term treatments with systematic exposure
- meds: SSRI/SNRI, short term benzo
What are the common disorders that are co-morbid with OCD?
- MDD
- social anxiety
- GAD
- ADHD or tic disorders in children
What is hoarding disorder?
-Persistent difficulty discarding regardless of value
What is the treatment of OCDs?
- CBT: exposure and response prevention
- SSRI/SNRI
- TCS: Anafranil is specific for OCD
What is adjustment disorder?
-Psychological response to an identifiable stressor resulting in clin all significant emotional or behavioral symptoms
What is the treatment for adjustment disorder?
- Psychotherapy
- pharmacotherapy for associated symptoms such as insomnia, anxiety, and depression
