Describe the incidence associated with anxiety disorders
- MOST PREVELENT psychiatric disorders
- Associated with a high burden of illness
- Often under recognized and under treated in primary care
- Women are 1.5 times more likely than men to receive a diagnosis of anxiety disorder
- Treatment is indicated when the patient shows marked distress or suffers from complications resulting from disorder
- Anxiety disorders should be treated with psychotherapy, pharmacotherapy or a combination of both
What are the subjective findings associated with anxiety?
- Restlessness/muscle tension
- Feeling threatened
- Panic – sympathetic nervous system
What are some physical manifestations of anxiety?
General physical manifestations:
- Urinary frequency/urgency
- Dry mouth
- Elevated vital signs
- Dilated pupils
- Muscular tension
How do you manage a patient with anxiety?
- Rule out medical causes, such as uncontrolled pain or desaturation
MILD anxiety: Initially, refer to mental health specialist for biofeedback or cognitive behavioral therapy
ACUTELY increasing anxiety: Remove stimulus causing anxiety first, then progress to pharmacologic management if necessary.
What 2 medications are used to treat anxiety?
- Short term use only
- Use with caution in elderly- may cause confusion and agitation
Buspirone (Buspar) – an SSRI
- Preferred over benzodiazepines when patient has an established diagnosis or anxiety disorder; does not provide immediate relief