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PM3B > (PM3B) Anxiety Disorders > Flashcards

(PM3B) Anxiety Disorders Flashcards

1
Q

What is anxiety?

A

Prolonged or exaggerated response

To a real or imagined threat

Interferes with normal life

Cannot be attributed to any known neurological or organic dysfunction

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2
Q

What percentage of the population have anxiety?

A

~15%

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3
Q

Is long-term drug treatment for anxiety recommended?

A

No

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4
Q

Which molecules in the blood mediate anxiety?

A

(1) Serotonin

(2) Noradrenaline

(3) Dopamine

(4) GABA

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5
Q

What are some psychiatric symptoms of anxiety?

A

(1) Fear/ tension/ apprehension/ panic/ terror

(2) Hyper-arousal excitability + outbursts of hostility

(3) Insomnia

(4) Circling thoughts + lapses of memory

(5) Inability to concentrate + easily distracted

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6
Q

What are some somatic symptoms of anxiety?

A

(1) Cardiovascular: palpitations/ increased BP/ tachycardia/ bradycardia/ flushing/ pallor

(2) Respiratory: rapid shallow breathing (hyperventilation)/ breathlessness (dyspnoea)

(3) GI: diarrhoea/ dyspepsia/ dysphagia/ churning stomach

(4) Musculoskeletal: agitation/ restlessness/ tremor/ muscle tension

(5) Metabolic: high blood glucose/ high glucocorticoids

(6) Excessive sweating/ urge to defecate or urinate

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7
Q

What are some different types of anxiety disorder?

A

(1) Generalised anxiety disorder – GAD

(2) Obsessive Compulsive Disorder – OCD

(3) Post-traumatic Stress Disorder – PTSD

(4) Panic Disorder – PD

(5) Specific phobias

(6) Social phobias

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8
Q

Describe the aetiology of anxiety?

A

No evidence of pathology of anxiety

OCD may be partially due to disturbed circuits

Some evidence for a genetic factor in some anxiety disorders – e.g. OCD

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9
Q

What are the treatment aims for anxiety therapy?

A

(1) Discover + remove cause

(2) Assess severity of anxiety response

(3) Relieve distress

(4) Implement long-term measures to prevent recurrence

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10
Q

What are some of the common psychological treatments for anxiety?

A

(1) Counselling

(2) Cognitive Behavioural Therapy (CBT)

(3) Exposure therapy

(4) Mindfulness + relaxation therapy

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11
Q

What is the phramacological treatment for acute anxiety?

A

Benzodiazepines

e.g. lorazepam/ diazepam/ alprazolam

Fast-acting relief

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12
Q

What is the usual first line treatment for most anxiety disorders?

A

(1) SSRIs – selective serotonin reuptake inhibitors

Recommended for long-term therapy

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13
Q

When is pregabalin indicated for treatment?

A

(1) Epilepsy

(2) Generalised anxiety disorder – GAD

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14
Q

When are tricyclic antidepressants indicated for treatment?

A

(1) Obsessions

(2) Phobias

e.g. clomipramine

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15
Q

When is buspirones indicated for treatment?

A

(1) Generalised anxiety disorder – GAD

(2) Acute anxiety

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16
Q

When are beta-blockers indicated for treatment?

A

Treatment of somatic symptoms of anxiety disorder

(1) Social phobias

(2) Panic disorders

17
Q

How is generalised anxiety disorder (GAD) diagnosed?

A

(1) DSM-V

(2) ICD-10

(3) GAD-7

18
Q

What is the maximum total score using the GAD-7 assessment scale?

A

21

7x3 points for ‘nearly every day’

19
Q

Using the GAD-7 scale, what are the cut-off points for mild, moderate, and severe generalised anxiety disorder?

A

(1) Mild: 5 points

(2) Moderate: 10 points

(3) Severe: 15 points

20
Q

What are the assessment criteria for GAD-7?

A

(1) Feeling afraid, as if something awful might happen
(2) Becoming easily annoyed or irritable
(3) Being so restless that it is hard to sit still
(4) Trouble relaxing
(5) Worrying too much about different things
(6) Not being able to stop or control worrying
(7) Feeling nervous, anxious, or on edge

21
Q

What are the stepped escalations of therapy for GAD?

A

(1) All known and suspected presentations of GAD

(2) Diagnosed GAD that has not improved after education and active monitoring in primary care

(3) GAD with an inadequate response to step 2 interventions or marked functional impairment

(4) Complex treatment-refractory GAD and very marked functional impairment, such as self-neglect or a high risk of self-harm

22
Q

What is usually the most beneficial and effective treatment for GAD?

A

Cognitive Behavioural Therapy – CBT

23
Q

What is the first line pharmacological treatment for GAD?

A

SSRIs – e.g. sertraline

12 weeks then reassess

24
Q

What is a recommended alternative to SSRIs for first line pharmacological treatment of GAD?

A

SNRIs

PM3B (33 decks)

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