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NEUROPSYCH & CLINICAL NEURO > Week 9: Anxiety disorders > Flashcards

Week 9: Anxiety disorders Flashcards

1
Q

What is anxiety?

A

Anxiety is an individual’s specific internal reaction to a perceived threat or stress

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2
Q

Is anxiety ever normal?

A

Yes in some situations.

It can help to motivate individuals or to warn of danger

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3
Q

How long does anxiety have to persist for it to be considered a disorder?

A

6 months or more

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4
Q

What are the physical symptoms of anxiety disorder?

A 
Sweating
Breathing changes
Hot flushes
Blushing
Dry mouth 
Shaking 
Hair loss
Fast heartbeat 
Lack of energy
Extreme tiredness
Dizziness/fainting
Stomach aches
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5
Q

Mental symptoms of anxiety?

A 
Racing thoughts 
Uncontrollable overthinking 
Difficulty concentrating 
Feelings of dread, panic or impending doom 
Feeling irritable 
Heightened alertness
Problems with sleep 
Changes in appetite 
Wanting to escape 
Dissociation
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6
Q

At what age can you be affected by anxiety?

A

At any age

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7
Q

Anxiety tends to appear…

A

Gradually

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8
Q

Are there any gender differences with anxiety?

A

Women are 2x as likely than men

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9
Q

Is anxiety genetic?

A

Yes there is some genetic link

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10
Q

What are the different types of anxiety disorders?

A 
Generalised anxiety disorder 
Panic disorder
Social anxiety disorder
Specific phobia 
Separation anxiety disorder 
Selective mutism 
Agoraphobia
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11
Q

What does the DSM5 say about generalised anxiety disorder?

A

Excessive anxiety or worry occurring for more days than not for at least 6 months about a number of things - the person finds it difficult to control the worry

The worry causes clinically significant distress or impairment in important areas of functioning.

This disturbance is not attributable to the physiological effects of a substance or a medical condition

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12
Q

The DSM5 requires 3 or more of the six symptoms for more days than not, for 6 months - what are the symptoms?

A

Restlessness or feeling on edge
Being easily fatigued
Difficulty concentrating or mind going blank
Irritability
Muscle tension
Sleep disturbance (falling asleep, staying asleep or unsatisfying sleep)

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13
Q

What is no longer included in the DSM5 under anxiety disorders?

A

Obsessive-compulsive - now under OCD and related disorders

Acute stress disorder and PTSD - now under trauma and stress-related disorders

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14
Q

What does anxiety increase the risk of?

A

Developing depression, alcohol, or other drug dependence as well as comorbidity with other anxiety disorders

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15
Q

Treatment for anxiety targets…

A

Serotonin, noradrenaline and GABA neurotransmitter systems

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16
Q

What is an anxiolytic?

A

A medication or any other intervention that reduces anxiety

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17
Q

What treatments are used for anxiety?

A

Psychotherapy
Medication
Healthy lifestyle

18
Q

What psychotherapy is used for anxiety?

A

CBT

19
Q

Psychotherapy when used with…… enhances the effectiveness of treatment

A

pharmacotherapy

20
Q

What kinds of medications are used for anxiety?

A

Anti-depressants (SSRI and SNRI)
Benzodiazepines
Barbiturates
Beta-blockers

21
Q

How long do anti-depressants take to have an anxiolytic effect?

A

4-6 weeks

- Anxiety is often slower to respond to treatment

22
Q

What is the first-line recommendation for anxiety? and why?

A

Anti-depressants

Little evidence of a dose-response curve and many patients do and continue to respond to standard doses

23
Q

What are serotonin pathways?

A

They are widespread in the brain - starting in the raphe nuclei that send major projections into the forebrain, cerebellum and the cortex

24
Q

What is buspirone?

A

It is a new drug that acts on the serotonergic system however it is a lot faster acting than SSRIs (acts partial post-synaptically on 5HTIA receptors, and full at pre-synaptic receptors)

25
Q

What are benzodiazepines?

A

Reduce both physical and mental symptoms in anxiety

26
Q

What is the disadvantage of benzodiazepines?

A

Their withdrawal symptoms are frequently mistaken as the anxiety returning (agitation, tension)

27
Q

What else can benzodiazepines be used for (other than anxiety)?

A

Alcohol dependence, seizures, insomnia

28
Q

Benzodiazepines are not….

A

the first line of treatment for anxiety

29
Q

What are barbiturates?

A

They have a sedative effect on the CNS - can be used as a sedative, anxiety reduction, hypnotic, anti-convulsants and anaesthetic

30
Q

What is the disadvantage of barbiturates?

A

They can be highly addictive and can be very dangerous if they are mismanaged

31
Q

Barbiturates act…

A

externally on the opening and closing of the chlorine channels - typically increasing duration of the GABA Cl channels

32
Q

Benzodiazepines act…

A

to increase the frequency of the GABA Cl channels opening

33
Q

Why are benzodiazepines better than barbiturates?

A

They cause less dependence

Long term use is relatively safe

Sleep induced is refreshing on wakeup - barbs cause hangover effect after waking

34
Q

What are beta-blockers?

A

They are used for blood pressure, heart conditions and extreme stage fright

35
Q

What is the main beta-blocker?

A

Propanolol

36
Q

How does propanolol work?

A

Acting on both post synaptic beta blocker 1 and 2 norepinephrine receptors - dampening down what causes us to be stressed

37
Q

Why hasn’t there been more treatments and medications made for anxiety?

A

How anxiety disorders work in the brain is not fully understood

38
Q

Progress in understanding the brain has not been reflected in…

A

improved clinical outcomes

39
Q

How do clinicians judge whether therapy is working?

A

Through the degree that patients report feeling better

40
Q

Is it possible to develop a pharmaceutical treatment that specifically targets anxiety?

A

Because of the diverse effects of the medications, this may be difficult to do so without producing effects on other phenomena

41
Q

What is the innate fear system?

A

Threat - sensory system - fear circuit - behaviour and physiological response (and conscious feelings of fear)

42
Q

What is the two-systems model of fear?

A

One system is for generating conscious feelings of fear (cognitive circuit)
One system is for controlling behavioural and physiological reactions (defensive survival circuit)

They both do have some interaction with each other

NEUROPSYCH & CLINICAL NEURO (12 decks)

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