Generalised anxiety disorder & OCD

Question 1

Anxiety is

Answer 1

feeling fearful, worried and tense on most days

about everything - if only one thing then its more likely a phobia

Question 2

diagnostic factors of generalised anxiety disorder

Answer 2

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a wide range of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

three or more (only one for children) of the following six symptoms,
restlessness or feeling keyed up or on edge;
being easily fatigued;
difficulty concentrating or mind going blank;
irritability
muscle tension;
sleep disturbance.

Question 3

risk factors for generalised anxiety disorder

Answer 3

Female
Being aged between 35 and 54.
Being divorced or separated.
Living alone or as a lone parent.

Question 4

management for suspected or diagnosed GAD - step 1

Answer 4

educate/monitor

Question 5

management - suspected or diagnosed GAD - step 2 - step 1 didnt help

Answer 5

low intensity psychological therapy

guided self help, psychoeducation group

Question 6

management - suspected or diagnosed GAD - step 3

Answer 6

CBT ?drugs (SSRI/SNRI)

Question 7

drugs for GAD

Answer 7

SSRIs or venlafaxine first line

escitalopram and paroxetine licenced for GAD

Question 8

Generalises anxiety disorder - what makes it more than just normal being anxious?

Answer 8

is it excessive (more than most), persistent (lasts longer than most) and unreasonable ( doesnt go away)

Question 9

Obsessive-compulsive disorder is characterised by what two things

Answer 9

1 - obsessions - unwanted, intrusive thoughts, images or urges which reoccur in mind
2 - compulsions - repetitive behaviour/mental acts which the patient feels driven to perform - ie checking a door is locked
Can be hidden - like saying a phrase in their mind over and over

need one/both for most days in two weeks
pt unsuccessfully tries to resist
cause distress

Question 10

OCD - treatment

Answer 10

first line - psychological intervention (via IAPT) CBT and ERP (exposure response prevention)

if not working - add a SSRI or higher intensity (more hours) psychological therapy

Question 11

Anxiety is really bad - crisis - what can you give SHORT TERM only

Answer 11

benzodiazepines