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PSYCHIATRY > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Give examples of the biological symptoms of anxiety.

A
  • Sweating, hot flushes or cold chills
  • Trembling
  • Muscle tension/aches/pains
  • Numbness or tingling sensations
  • Feeling dizzy, unsteady, faint or lightheaded
  • Dry mouth (not due to medication or dehydration)
  • Feeling of choking
  • Lump in the throat, or difficulty in swallowing
  • Difficulty breathing
  • Palpitations
  • Chest pain
  • Nausea /churning in stomach
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2
Q

Give examples of the cognitive symptoms caused by anxiety

A
  • Fear of losing control
  • Difficulty concentrating, “mind going blank”
  • Feeling that objects are unreal - derealization
  • Feeling that the self is distant - depersonalisation
  • Hypervigilance (internal and external)
  • Racing thoughts
  • Meta-worry
  • Health anxiety
  • Preference for order and routine
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3
Q

What behavioural symptoms indicate anxiety?

A
  • Avoidance of situations
  • Exaggerated response to minor surprises/startled
  • Difficulty sleeping due to worrying
  • Excessive use of alcohol/drugs
  • Restlessness/ irritability
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4
Q

Acute stress increases cortisol levels. TRUE/FALSE?

A

TRUE

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5
Q

When is anxiety considered pathological?

A
  • when anxiety is more extreme than “normal”

- when anxiety presents in certain situations that are not “normally” anxiety provoking

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6
Q

Give examples of types of anxiety disorder?

A 
Generalised Anxiety Disorder
Panic Disorder
Agoraphobia
Social Phobia
Specific Phobia
Obsessive Compulsive Disorder
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7
Q

What is meant by Generalised Anxiety Disorder?

A
  • generalised and persistent anxiety
  • not in any particular circumstance or environment
  • long-lasting (most days for at least 6 months)
  • not controllable
  • causing significant distress / impairment in function
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8
Q

What symptoms of anxiety are typically found in Generalised Anxiety Disorder?

A
  • restlessness
  • easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance
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9
Q

Who normally gets Generalised Anxiety Disorder?

A

Typical age of onset between 20-40

2:1 female:male ratio

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10
Q

What percentage of patient’s with Generalised Anxiety disorder also have other co-morbid psychiatric disorders (e.g. depression, substance abuse etc)

A

90%

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11
Q

How is generalised anxiety disorder treated?

A
  • Cognitive Behavioural Therapy
  • SSRIs / SNRIs
  • Pregabalin
  • Benzodiazepines (short term only)
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12
Q

What is CBT and how does it work?

A
  • Talking therapy
  • identifying individual’s automatic thoughts, cognitive biases and schemas
  • Help the individual understand why their thoughts are pathological/harmful and perpetuate the anxiety
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13
Q

What is panic disorder?

A
  • recurrent attacks of severe anxiety
  • not restricted to any particular situation
  • unpredictable
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14
Q

What symptoms and thoughts are experienced in a panic disorder?

A

palpitations
chest pain
choking sensations
dizziness
feelings of unreality (depersonalization or derealization)
Secondary fear of dying/losing control/going mad

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15
Q

Many patients with panic disorder also have agoraphobia. TRUE/FALSE?

A

TRUE

50-67%

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16
Q

When is the typical onset of panic disorder?

A

Late adolescence to mid-30’s

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17
Q

How many people have recovered or improved at 10 year follow up of a panic disorder?

A

1/3 unchanged or worse
1/3 modest improvement
1/3 well

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18
Q

How are panic disorders treated?

A

Cognitive Behavioural Therapy
SSRIs / SNRIs / Tricyclics

Benzodiazepines (short term only)

19
Q

When do phobias typically present?

A
  • Agoraphobia = 20-30s

- Social and Specific phobias = early adolescence - early 20’s

20
Q

Do patients with a phobia recognise their fear is irrational?

A

Yes

21
Q

What is agoraphobia?

A

cluster of phobias:

  • fears of leaving home
  • entering shops
  • crowds
  • public places
  • Travelling alone in trains, buses or planes
22
Q

Sometimes patients with agoraphobia can avoid their stimulus so much that they experience very little anxiety. TRUE/FALSE?

A

TRUE

23
Q

What are the signs of agoraphobia in relation to shopping?

A

others do shopping (for or with the patient)
go shopping to 24 hour store at night (when quiet)
Internet shopping!

24
Q

Why do patients with agoraphobia often drink alcohol?

A
  • to overcome fear and allow them to go out and do tasks they wouldn’t previously do
25
Q

Give examples of specific phobias

A

flying, heights, animals or insects, receiving an injection or seeing blood

26
Q

How are specific phobias treated?

A

Behavioural Therapy – exposure
Graded exposure / systematic desensitisation
Add in CBT if necessary

SSRIs / SNRIs if required

27
Q

What is social phobia/social anxiety disorder?

A
  • persistent fear where person is exposed to unfamiliar people or to scrutiny by others
  • fears that he or she will act in a way that will be embarrassing and humiliating
28
Q

Social phobia can cause problems with poor school performance. TRUE/FALSE?

A

TRUE
school refusal causes poorer results
may cause poor employment

29
Q

How is social phobia treated?

A

Cognitive Behavioural Therapy
SSRIs / SNRIs

Benzodiazepines (short term only)

30
Q

What type of thoughts are typical of OCD?

A

Ego-dystonic

=> thoughts that are distressing/ unacceptable or inconsistent with one’s self-concept.

31
Q

What is meant by the “compulsive acts” involved in OCD?

A
  • Repeated rituals or stereotyped behaviours
  • Not enjoyable/ pointless acts
  • Often viewed as “neutralising” aka will stop something bad from happening
32
Q

How is OCD diagnosed?

A

Obsessive symptoms/ compulsive acts present most days for at least 2 weeks
AND these are source of distress and interference with activities

33
Q

Name some of the common obsessions associated with OCD?

A

Contamination
Fear of Harm
Concern with order/symmetry

34
Q

Name some of the common compulsive acts of OCD?

A

Checking
cleaning/washing
repeating acts

35
Q

When is the typical onset of OCD?

A

mean age of onset – 20
peak incidence for males – 13-15
peak incidence for females – 24-25

36
Q

What percantage of OCD patients experience at least 1 depressive episode?

A

60-90%

37
Q

What comorbidities (other psychiatric conditions) can accompany OCD?

A

schizophrenia
Tourettes and other tic disorders
Body dysmorphic disorder
Eating disorders

38
Q

How is OCD treated?

A

Cognitive Behavioural Therapy
Including response prevention
SSRIs / Clomipramine

39
Q

HOw do benzodiazepines help to treat anxiety

A 
Bind to GABA-A receptor
Allow Chlordie ion influx
Membrane hyperpolarisation
=> NO AP generated
and neurons dont fire
40
Q

What problems can occur with benzodiazepines if they are used for longer than 2 weeks?

A
  • Sedation and psychomotor impairment
  • withdrawal problems
  • Dependency and abuse
  • Alcohol interaction
  • Can worsen co-morbid depression
41
Q

What type of medication is first line in OCD?

A

SSRI

42
Q

OCD is highly comorbid with other disorders. TRUE/FALSE?

A

TRUE

43
Q

What is the difference between obsessive thoughts and mental compulsions?

A

Mental compulsions involve patient role-playing their compulsion in their head
=> i.e. counting to certain number, imagining they are completing a task etc

PSYCHIATRY (35 decks)

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