PH3113 - Psychiatric Disease and its Pharmacology 1 Flashcards
What is the Yerkes-Dodson curve?
Spectrum of anxiety the peak performance happens when the body is subject to some stress, but not too much
What does excessive anxiety cause?
Decreased capacity for skilled motor movements
Decreased complex intellectual tasks
Decreased perception of new information
What is clinical anxiety?
A normal, protective psychological response to an unpleasant/threatening situation
What can excessive anxiety lead to?
Severe distress and impair social functioning
What is the difference between a pathological and normal state of anxiety?
Hard to distinguish
- represents the point at which the symptoms interfere with normal, productive activites
Give some examples of anxiety disorders?
Specific phobia
Panic disorder
Agoraphobia
Selective mutism
Separation anxiety disorder
Generalised anxiety disorder
Unspecified anxiety disorder
Other specified anxiety disorder
Social anxiety disorder
- social phobia
Anxiety disorder due to another medical condition
Substance/medication-induced anxiety disorder
What is generalised anxiety disorder (GAD)?
Persistent anxiety
- unlikely to have specific triggers
Diagnosis made after more than 6 months of excess worry or anxiety on most days
Patient cannot control it easily
3 or more of the following are present for more than 6 months
- restless/on edge
- easily fatigued
- difficulty concentrating
- irritability
- muscle tension
- sleep disturbances
What is panic disorder?
Recurrent panic attacks
Worry about future attacks, or consequences of one
Change in behaviour as a result
What is a specific phobia?
Excessive fear of specific situations or objects
- avoidance behaviour
- change in social function
What is social anxiety disorder?
Similar to phobias
- triggered by social situations
What is Obsessive-Compulsive Disorder (OCD)?
Preoccupation and recurrent thoughts with an object or activity
- obsessions
- stress and anxiety from persistent thoughts or impulses
- not explained by specific life events
- recognised as a product of their own mind
- compulsions
- driven to repetitive behaviours
- unrealistic avoidance methods
What is Post-Traumatic Stress Disorder (PTSD)?
Reaction to a traumatic event
Continued experience with triggers
2 or more of the following, for more than one month
- insomnia
- irritability/bouts of anger
- poor concentration
- increased vigilance
- exaggerated response to non-threatening stimuli
- car back-firing
- dropping something
What is the prevalence of generalised anxiety?
Most commonly reported mental illness
- lifetime prevalence of 21%
Age on onset typically in young adults
- 20s and 30s
Female to male ratio 2:1
- males less likely to seek help/see GP
Often more than one anxiety disorder and 2/3 of sufferers will have another mental illness
- most commonly depression
- eating disorders
What are the symptoms of anxiety?
Overactivity in the sympathetic nervous system
- palpitations
- tachycardia
- breathlessness
- tachypnoea
- faintness, dizziness
- blood flow to musculature
- sweating
- sweat gland activity
- flushes
- vasomotor instability
- dry mouth
- salivation
- cold extremities
- peripheral vasoconstriction
- piloerection
- erection of hairs
- fatigue
Overactivity in the parasympathetic nervous system
- frequency/urgency of micturation
- bladder tone
- diarrhoea
- peristalsis
Overactivity in the somatic efferent nervous system
- increased muscle tension
- headache
- facial pain
- chest pain/tightness
- intercostal muscles
- trembling
- beta-2 sympathetic effect on muscles
- adrenergic release
- fatigue
What is the pathophysiology of anxiety?
Disturbance of the arousal systems in the brain
Arousal maintained by at least three interconnected systems
- a general arousal system
- an emotional arousal system
- an endocrine/autonomic arousal system
Excess activity in the general arousal system can lead to hyperarousal
- mediated by the
- brainstem reticular formation
- thalamic nuclei
- basal forebrain bundle
Increased activity in the ‘emotional arousal system
- limbic system
- anxiety and panic attacks
