Panic Disorder & Phobias Flashcards
What is panic disorder?
recurrent attacks of anxiety not triggered by any particular situation or set of circumstances i.e. unpredictable
NOTE: Symptoms do not satisfy criteria for GAD, depression or other psych disorders
Duration of panic attacks to be classed as panic disorder
> 1 month
Presentation of panic disorder
Palpitations
Sweating
Tremor
Chest tightness
Sudden onset and “out of the blue”
Thoughts of doom/urgently seeking safety
How to diagnose panic disorder?
Diagnosis of exclusion –> rule out things like AF
Management of panic disorders
Education, reassurance and self help (IAPT)
Medication used in severe cases – SSRI, trial TCA or benzo if no improvement
PACES: Why do we not give benzodiazepines routinely?
Provide only symptomatic relief of anxiety and should only be used in the short term, because of their highly addictive nature.
Patients become tolerant of their effects within 2 weeks
Their prescription delays other treatment strategies being put in place, and people who take them perform less well in psychological therapy sessions
Even if patients do not develop addiction to them, they experience withdrawal of their sedating effects and the frequency of panics can increase
In the long term, patients prescribed benzodiazepines as primary treatment have a worse outcome
Social phobia
fear of scrutiny by other people leading to avoidance of situation
Agoraphobia
cluster of phobias defined by being unable to escape a place of people e.g. leaving home, crowds, entering shops, planes/buses etc
Investigations of phobia
Full history
SPIN/Social Phobia Inventory or Liebowitz social phobia scale to assess degree of social phobia
PACES: What screening tools can be used for assessment of degree of social phobia?
SPIN/Social Phobia Inventory or Liebowitz social phobia scale
Management of phobias
conservative + CBT with ERP/Exposure and Response Prevention focus
Therapies summary table
