Anxiety and Adjustment Disorder Flashcards
(24 cards)
Cardiac symptoms of anxiety
Palpitations, tachycardia and hypertension
Pulm symptoms of anxiety
SOB, choking sensation
Neuro symptoms of anxiety
Dizziness, light headedness, hyper reflexia, mydriasis, tremors, tingling in extremities.
Psychological symptoms of anxiety
Restlessness, butterflies
Anxiety
Subjective experience of fear and its physical manifestations. Typically a normal response but can be pathologic
MEdical causes of anxiety
Hyperthyroidism, B12 def, Hypoxia, Neurologic disorders, CVD, Anemia, Pheochromocytoma, Hypoglycemia
Substance abuse related anxiety disorders
Caffeine intake, theophylline, amphetamines, alcohol, mercury and arsenic poisoning, penicillin, sulfonamides, sympathomimetics, anntidepressants
Panic Attakc
Discrete exacerbations of anxiety and fear that often occur in patients with anxiety disorder
Attacks occur within 10 minutes of stimulus and last less than 25 mins
Must have at least 4 of the following: palpitations, sweating, shaking, SOB, choking sensation, chest pain, nausea or abdominal distress, light-headedness, depersonalization.
Comorbid conditions associated with panic attack:
Mitral Valve prolapse Asthma Pulmonary embolus angina anaphylaxis
Panic Disorder
Spontaneous and recurrent panic attacks with no obvious precipitant
Suffer on average 2 per week (last 20-30 minutes)
Treatment of Panic Disorder
SSRIs: Paroxetine and Sertaline
Benzodiazepines: For abortion of anxiety, use temp
Agoraphobia
The fear of being alone in public spaces ( fear is that help or escape are difficult to find)
Phobia
Irrational fear that leads to the avoidance of the feared object or situation
Patient knows that the fear is excessive and duration of this fear must be at least 6 months.
The fear must interfere with their daily living
Treatment of Specific Phobia
Behaviour therapy
Treatment of Social Phobia
Paroxetine (and other SSRIs) , beta-blockers are often used for performance anxiety
Obsessive Compulsive Disorder
Obsession: a recurrent and intrusive thought, feeling or idea that is egodystonic (against the goals of the ego ?)
Compulsion: conscious repetitive behavior linked to an obsession that helps relieve anxiety caused by the obsession when performed
AXIS I DISORDER: Generally aware of the problem and realize their obsession and compulsions are irrational. There is significant distress in their lives.
Treatment of OCD
SSRI: First line, may require higher than normal doses
TCA’s
BEHAVIORAL TREATMENT (Exposure and Response prevention_
ECT
What are the classification of Obsessions
Contamination –> Excessive Hand Washing
Doubt –> Repetitive task like turning lights off
Symmetry:
Intrusive (often violent or sexual)
Somatic: View parts of body etc as abnormal
Obsessive Compulsive Personality Disorder
Patient is excessively preoccupied with detail, lists and organization
PTSD
- Witnessed or Experienced a traumatic Event (really Asante said you must experience a near death event) which caused intense fear and anxiety .
- Persistent re-experiencing of the event
- Avoidance of stimuli associated with the event
- Hypervigilence with increased arousal.
SYMPTOMS MUST BE FOR AT LEAST ONE MONTH.
Often abuse and depression are comorbid
Treatment of PTST
SSRI, TCA and MAOi . Anticonvulsants also
Behavioral therapy is useful
Acute Stress Disorder
Stressor occurred less than a month previously and Symptoms last less than 1 month
Symptoms otherwise are similar to
Generalized Anxiety Disorder
Excessive anxiety and worry about daily events and activities (many aspects of daily life) for at least 6 MONTHS
Must be associated with 3 of the following : Restlessness, Fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance. `
Treatment of Generalized Anxiety Disorder
Antidepressants :SSRI , buspirone, venlafexine
Benzodiazepines: Clozepam and Diazepam. Should be tapered off due to risk of dependence.
