Neurotic disorders Flashcards
What are the neurotic disorders?
Generalised anxiety Panic disorder Phobic disorder OCD PTSD
Factors associated with neurotic disorders?
Low social class Unemployment Divorced/separated/widowed Renting rather than owning No educational qualifications Urban rather than rural
Fight or flight response?
Pallor Mydriasis Inc resp rate Inc heart rate Inc blood sugar Inc metabolic rate Inc blood flow to muscles Dec bowel/bladder function Constriction of smooth muscle in skin Sweating
What is generalised anxiety disorder?
Ongoing anxiety and worry about many events or thoughts that the patient thinks are excessive and debilitating
Physical symptoms of anxiety
Tension headaches Muscle tension Dizziness Flushes Dry mouth Dysphagia Restlessness Fatigue Breathlessness Tachycardia Sweating Cool, clammy hands Trembling GI discomfort, nausea, vomiting Urinary frequency
What is a panic attack?
Unexpected severe exacerbation os psychic and somatic anxiety symptoms with intense fear or discomfort
Psychological symptoms of anxiety?
Feelings of threat Poor concentration On edge, tense Insomnia, nightmares Noise intolerance Inattention Misinterpretation Lability of mood Depersonalisation Derealisation Perceptual distortion Hypnagogic and hypnopompic hallucinations
What is depersonalisation?
Altered sense of personal reality or identity - Who am I?
What is derealisation?
Altered/unreal surroundings - Where am I?
What is a perceptual distortion?
Incorrect understanding or abnormal interpretation of a perceptual experience
What is cardiac neurosis?
Patient forgets about cause of anxiety and worries about having a heart attack
Anxiety symptom differentials?
Generalised anxiety Panic disorder Phobic disorder OCD Depressive disorder Schizophrenia Drug/alcohol withdrawal Early dementia Thyrotoxicosis Pheochromocytoma Unexpressed complaints of physical illness Drug and alcohol abuse
What is progressive muscle relaxation?
isolated contraction of different muscles - mind relaxation follows muscle relaxation
Type of breathing exercise in anxiety?
Square breathing - in for 4, hold for 4, out for 4, wait for 4 - repeat
What is panic disorder?
Recurrent attacks of severe anxiety not restricted to any particular situation Last for minutes Impending sense of doom Freedom between attacks Anticipatory anxiety
Phobic disorder?
Anxiety evoked by specific well-defined situations which are not currently dangerous
Types of phobic disorder?
Specific phobia
Agoraphobia
Social phobia
What is specific phobia?
Restricted to highly specific situations e.g. animals, heights, thunder, flying
What is agoraphobia?
Fear of open spaces, crowds, difficulty in immediate escape from situations
What is social phobia?
Fear of scrutiny of other people in comparatively small groups, leading to avoidance of social situations
What is graded exposure?
Rank phobic situations from most manageable to least and work through exposure to each
What is flooding?
Maximal exposure to fear stimulus until anxiety reduction or exhaustion occurs
What is OCD?
Recurrent obsessional thoughts or compulsive acts
Unsuccessful resistance
Thought of carrying out act is not pleasurable
Thoughts, images, impulses must be unpleasantly repetitive
Increased risk of OCD
Anakastic PD
Tertiary syphilis
Brain injury
Encephalitis
What is PTSD?
Severe reaction to extremely stressful circumstances
Characterised by flashbacks/reliving the episode
Emotional blunting
Hyperarousal
Within 6 months of event
What is acute stress reaction?
Transient - hours/days
Response to stressful event
Changing symptoms
What are symptoms of acute stress reaction?
Initial daze Anxiety Depression Anger Despair Overactivity Withdrawal
What is an adjustment disorder?
Emotional distress following a significant life event
Affects social functioning
Onset within one month of event
Lasts less than 6 months
What is circumstantiality?
Over-inclusive speech that is delayed in reaching its final goal
Can follow the speech, and it does eventually reach its goal
Sign of anxiety or hypomania
How long should PTSD symptoms be present for diagnosis?
1 month
