Mood and Anxiety Disorders Flashcards
At what age does panic disorder commonly present?
early teens thru 40s
Social phobia or social anxiety disorder presents at what age?
bimodal: 5 yo or early adolescence
onset of phobias of animals
5 yo
onset of phobia of blood
9 yo
onset of phobia of situations
2-7 yo and early 20s
**may remit with experience
Onset of OCD
male: 6-15 yo
female: 20-29
* *onset is GRADUAL
onset of GAD
mid teens to mid 20s
refers to fear, often with blushing, of anticipated humiliation or rejection by others in social situations.
Desires social interactions/relationships but the dread of embarrassment leads to avoidance
social phobia
when do simple phobias need to be treated?
when they interfere with important activities
What is agoraphobia
marked, persistent fear or anxiety about 2 or MORE of the following situations:
- using public transportation
- being in open spaces (parking lots, bridges, marketplaces)
- being in shops, theaters, cinemas
- standing in line or being in a crowd
- being outside of the home alone
Are panic attacks assc with agotaphobia
yes (but you do not have to have them to be diagnosed with agoraphobia)
treatment for social phobia
rehearsal, improved competence, beta blockers (to reduce distress for public speaking)
treatment for simple phobia
short acting benzos (short term tx = flying, claustrophobia in MRI); repeated gradual exposure
treatment for agoraphobia
gradual exposure + SSRIs
somatic symptoms are often the chief complaint with this disorder
GAD
characterized by intrusive arousal (obsessive thoughts and unjustified guilt) and avoidance symptoms
OCD
do people with OCD realize thatt thoughts are irrational
yes
What substances/medication can induce anxiety disorder?
cocaine, methamphetamines, ADHD meds, Caffeine, alcohol withdrawals, OTC decongestions and cough syrup
Medical conditions that can cause anxiety disorder
pheochromocytoma hyperthyroid hypoglycemia metabolic problems Neuro problems
Symptoms needed to diagnose major depressive episode
SIG E CAPS Need FIVE of them Sleep loss of Interest Guilt decreased Energy Concentration difficulty Appetite disturbance Psychomotor retardation/agitation Suicidal thoughts
how to diagnose Persistent Depressive Disorder
SIG E CAPS for 2 or more YEARS; never without symptoms; causing clinically significant distress or impairment
diagnosis is PMDD
1 week before onset of menses, marked affective:
-lability, irritability, anger, interpersonal conflicts, feeling on edge, anxiety, depression, over-eating, food cravings, sleep problems, feeling overwhelmed and out of controk
1 YEAR HISTORY AND DOCUMENTED PROSPECTIVELY FOR AT LEAST 2 CYCLES
dythymia and hypomania; milder form of bipolar
cyclothymic disorder
time line to diagnose cyclothymic disorder
last at least 2 years
patient loses contact with reality; severely impaired judgment
bipolar 1
diagnositic criteria for bipolar 1
mania for at least ONE WEEK with or without an episode of depression or hypomania
characterize pt with bipolar II disorder
manic phase rarely are as disruptive as bipolar I but they have more significant/recurring depression
**function returns to nml between episodes
which brain structure is involved in the following sign/symptom of a mood disorder:
depressed people cannot access happy memories and mania makes sad memory inaccessible
hippocampus
which brain structure is involved in the following sign/symptom of a mood disorder:
compromised attention/concentration
thalamus
which brain structure is involved in the following sign/symptom of a mood disorder:
helplessness, indecisiveness, distorted sense of time
dorsolateral prefrontal cortex
which brain structure is involved in the following sign/symptom of a mood disorder:
overestimation of risk and reduced reward in depression
underestimation of risk in mania
orbitofrontal cortex
which brain structure is involved in the following sign/symptom of a mood disorder:
abnormal motivation (apathy in depression) dysregulation of arousal
anterior cingulate gyrus
which brain structure is involved in the following sign/symptom of a mood disorder:
anxiety, irritability, vigilance, hypersensitive to neg enviro cues
amygdala
which brain structure is involved in the following sign/symptom of a mood disorder:
lack of pleasure
nucleus accumbens
which brain structure is involved in the following sign/symptom of a mood disorder:
insomnia/hyperinsomnia
lack of sexual interest
hyperphagia or anorexia
HPA axis