General Anxiety Disorder Flashcards

1
Q

What is Yerkes-Dodson Law?

A

how anxiety/arousal affects performance

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2
Q

What is abnormal anxiety?

A
  • excessively intense/disproportionate to the stimulus
  • triggered by harmless situations
  • occurs without a cause
  • continues beyond exposure to danger
  • can’t be controlled
  • causes distress
  • impairs functioning
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3
Q

What is needed for a diagnosis of GAD?

A
  • persistent fear and worry
  • plus 3 of the following: poor concentration, restlessness, fatigue, muscle tension, initial insomnia
  • symptoms for >6months

CAN’T have:

  • alcohol of street drug misuse
  • hyperthyroidism
  • phaeochromocytoma
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4
Q

What are the different types of symptoms for GAD?

A
  • psychological
  • physical
  • behavioural
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5
Q

What are the psychological symptoms of GAD?

A
  • constant worry, intrusive thoughts
  • feeling of apprehension and dread
  • poor concentration
  • (if severe) depersonalisation, derealisation
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6
Q

What are the physical symptoms of GAD?

A
  • tremor, sweetness, “butterflies”, palpitations
  • muscular tension, tension headache
  • hyperventilation (difficulty taking a breath, “atypical” chest pain, parasthesiae in hands, feet and lips)
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7
Q

What are the behavioural symptoms of GAD?

A
  • putting things off because if anxiety
  • avoidance of particular situations
  • “self medication”: misuse of drugs or alocol to relieve anxiety
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8
Q

What is the percentage of GAD in women? in men?

What age is it most common, what is the median age of onset?

A

women: 5.3%
men: 2.8%
- most common in young adult life median age on onset in 30y

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9
Q

What is the aetiology of GAD?

A
  • 1st degree family history GAD increases risk by 2.5x
  • molecular genetics (GWAS)
  • overactive amygdala
  • childhood trauma, parental rejection or over control
  • major life stress
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10
Q

What are the treatment of GAD?

A
  • psychological therapy (CBT, muscular relaxation, mindfulness, online help lines)
  • medication (SSRIs, tricyclic antidepressants, pregabapentin, benzodiazepines, beta blockers
  • lifestyle changes
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11
Q

From what is GABA synthesised and what synthesises it?

A

-glutamic acid decarboxylation (from glutamic acid to gamma-amino butyric acid (GABA))

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12
Q

What kind of receptor is GABA?

A

transmembrane, ligand-gated ion channel receptor

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13
Q

What are the different subunits, and how are they arranged?

A

alpha1, beta 2, alpha1, gamma2, beta2

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14
Q

Where does GABA bind on the receptor? What does it cause?

A
  • between alpha and beta subunit

- cause Cl ions to flow into neurone, leading to hyper polarisation

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15
Q

Where does benzodiazepines bind? What does it do?

A
  • between alpha and gamma subunit (has to be alpha 1, 2 or 3 and gamma 2 or 3)
  • potentiates action of GABA and increases Cl- influx: positive allosteric modulator (POM) at GABA receptor: increase frequency of opening of Cl channels
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16
Q

Where do barbiturates bind? what do they do?

A

-beta gamma2, 3 subunits and alpha 1,2 or 3 and gamma 2 or 3

increase duration of cl- channels opening

17
Q

what are the GABA receptors with alpha 1 subunits used to modulate?

A

sleep

18
Q

what are GABA receptors with alpha 2 or 3 subunit used to modulate?

A

anxiety

19
Q

What are Z drugs?

A

hypnotics (bind between alpha 1 and gamma subunits)

20
Q

Where does alcohol, general anaesthetics and neurosteroids bind to?

A

between alpha 4 or 6 and delta subunits on GABA-A receptors