Psychological Disorders and Illnesses Flashcards
What are the symptoms of anxiety?
- palpitations
- pounding heart
- accelearted heart rate
- trembling or shaking
- difficulty breathing
- chest pain or discomfort
- feeling dizzy
- fear of losing control
- muscle tension or aches
- sweating
- dry mouthh
- feeling of choking
- nausea or abdominal discomfort
- fear of dying etc.
What is Generalised Anxiety Disorder?
GAD = marked by a chronic, high level of anziety that is not tied to any specific threat -
excessive worry about work, family, health etc.
worry occurs most days for at least 6 hours
difficult to control
frequency of anxiety symptoms
associated with disturbed sleep
pure GAD are rare- often mixed with anziety and depression
What are the criteria for a major depressive disorder according to DSM5 ?
- depressed mood
- substantial weight loss/gain
- insomnia/hypersomnia
- feelings of worthlessness or inappropriate guilt
- suicidal ideation or attempts
- anhedonia - inability to feel pleasure
- fatigue or loss of energy
- psychomotor agitation/retardiation
- diminished ability to think/concentrate
- at least 5 symptoms must be present for at least 2 weeks and this should be a change from normal
What is the prevalence of MI in depressed patients?
20% of depressed patients experience MI
compared to the general population (6%)
what is the link between anxiety and incident of corinary heart disease
26% increased risk of incident CHD in those with anxiety symptoms
anxiety is associated with what?
depression is associated with what?
anxiety = associated with increased risk of CHD - but effects relatively small
depression = associated with increased risk of CHD - effects are larger than for anxiety - consistent effects may be more important for prognosis than anxiety
patients with psychological disorder and a physical illness…
- worry more about physical symptoms
- interpret symptoms catastrophically
- present more frequently to GPs
- less likely to be satisfied with treatment
- less likely to adhere to recommendations
*
are depressed patients more or less likely to quit smoking than non-depressed patients?
depressed patients are less likely to quit smoking than non-depressed patients
Should we screen for depression in coronary heart disease patients?
yes- better their quality of life
ask the following
1) during the past months, have you often been bothered by feeling down, depressed, or hopeless?
2) during the past month, have you often been obthered by little interest or pleasure in doing things?
- it is 90% sensitivity and 69% specificity - it DOES rule out depression
what are the ‘core’ diagnostic symptoms of anxiety?
1) feeling nervous, anxious or on edge
2) not being able to stop or control worrying
3) worrying too much about different things
4) trouble relaxing
5) being so restless that it’s hard to sit still
6) becoming easily annoyed or irritable
7) feeling afraid as if something awful might happen
scale the above from 0-3 (3 being nearly every day)- scores of 10+ require more thorough investigation
what antidepressants are safe for patients with coronary heart disease?
only SSRIs are safe for coronary heart disease patients
Does Treating depression, social isolation reduce mortality in MI patients?
no, for cognitive-behavioural therapy and or antidepressants - treatment did reduce depression though and improve quality of life
