Neuroses

Question 1

What is GAD?

Answer 1

Generalised, persistent excessive anxiety or worry about a number of events that are hard to control lasting 6 months or longer.

Question 2

What psychological symptoms manifest with GAD?

Answer 2

Irritability
Impatience
Fear
Derealisation
Depersonalisation

Question 3

What arousal symptoms manifest in GAD?

Answer 3

Increased vigilance
Restlessness
Increased startle response
Decreased sleep

Question 4

What Physical symptoms manifest in GAD by system?

Answer 4

Tachycardia, palpitations, chest pain, 
Nausea,  Dry mouth, choking sensation, GORD, flatulence, diarrhoea,
Hyperventilation
Excessive urination 
Sweating,

Question 5

What neurological symptoms manifest in GAD?

Answer 5

Tinnitus
Light headed
Tremor
Headache
Motor tension

Question 6

What are the biological causes of GAD?

Answer 6

Low GABA levels lead to reduced activity in the nervous system resulting in anxiety

Question 7

What structural changes occur in GAD?

Answer 7

Amygdala and frontal cortex remodelling

Question 8

What are the risk factors for GAD?

Answer 8

Family history ++
GAD and depression genetically related
Age 33-55
Divorced or separated
Living alone
Lone parent

Question 9

What is protective against GAD?

Answer 9

Married or cohabiting

Age 16-24

Question 10

What causes from childhood are relevant to GAD?

Answer 10

Child abuse
Trauma
Separations
Demands for high achievement
Excessive conformity

Question 11

How is stress linked to GAD?

Answer 11

Traumatic life events
Physical disease (COPD especially as feel breathless)

Question 12

What is the treatment pathway for GAD?

Answer 12

Education
Low intensity psychological interventions, self help
CBT or SSRIs/SNRIs
Inpatient MDT

Question 13

What is the time limit for using benzos?

Answer 13

3-5 days

Question 14

What is given to those with GAD and palpitations?

Answer 14

Beta blockers (propanolol)

Question 15

What is second line to SSRIs/SNRIs in GAD?

Answer 15

Pregabalin

Question 16

What is the treatment for phobias?

Answer 16

CBT

Exposure therapy

Question 17

What are hypnotics used for?

Answer 17

Insomnia

Question 18

Name some hypnotics and what is the issue

Answer 18

Zopiclone
Zolpiden
Can be addictive

Question 19

What is the mechanism of action for hypnotics?

Answer 19

GABA inhibitors like Benzos

Question 20

What are anxiolytics?

Answer 20

Benzos.

Used for sleep induction and muscle relaxation

Question 21

What are the indications for anxiolytics?

Answer 21

Short term generalised anxiety
Withdrawal states
Control of violent behaviour

Question 22

Which are long acting benzos?

Answer 22

Diazepam

Nitrazepam

Question 23

What are short acting benzos?

Answer 23

Lorazepam

Temazepam

Question 24

What are the side effects of Benzos?

Answer 24

Drowsiness
Ataxia (falls risk in elderly)
Amnesia
Dependence
Disinhibition->  Agression

Question 25

What does benzo withdrawal look like?

Answer 25

``` Shakiness Anxiety Abdo cramps Perceptual delusions Seizures ```

Question 26

What happens when you start and stop benzos to dreams?

Answer 26

Stop when start | Rebound when stop

Question 27

What does benzo overdose look like?

Answer 27

Respiratory distress Drowsiness Ataxia Dysarthria

Question 28

How do you treat Benzo OD?

Answer 28

FLUMAZENIL

Question 29

Wich antidepressant is sedative?

Answer 29

Mirtazapine

Question 30

What is a phobia?

Answer 30

Anxiety evoked in a well defined situation that is not currently dangerous

Question 31

What is panic disorder

Answer 31

3 panic attacks in 3 weeks lasting up to 10 minutes not retricted by setting or circumstance so unpredicatble

Question 32

What is needed for a diagnosis of OCD?

Answer 32

Activity to take up to an hour a day for over 2 weeks

Question 33

How is OCD treated?

Answer 33

SSRIs | CBT

Question 34

How is PTSD treated?

Answer 34

CBT EMDR- eye movement desensitising reprocessing Paroxetine/Mirtazapine

Question 35

How long do you need to experience symptoms for PTSD?

Answer 35

Over a month

Question 36

What is adjustment disorder?

Answer 36

Onset within weeks or months of trauma that last up to 6 months with wide ranging symptoms of depression, anxiety, autonomic arousal but insuffient for depression or anxiety diagnosis

Question 37

How is adjustment disorder treated?

Answer 37

CBT | Practical support

Question 38

What is an acute stress reaction?

Answer 38

Minutes to hours after an event to a few days later Dazed, perplexed and anxious Depression, angerm despair, purposeless overactivity

Question 39

What is somatisation disoder?

Answer 39

Over 2 years of symptoms with physical explanations

Question 40

WHat is persistent somatiform pain disorder?

Answer 40

physical symtom with no physical cause