Flashcards in Anxiety and adjustment disorders Deck (30):
What are the criteria for panic disorder?
recurrent panic attacks and a panic attack followed by at least 1 month of worrying about the next one
A 16 year old patient presents with mania and appears to be pregnant. What therapy should be offered?
How does bipolar diagnosis in kids differ than adults?
Adolescent mania more often accompanied by psychotic features, more commonly confused with ODD or ADHD
Need to meet all DSM criteria including 1 week criterion
What is the major classification for panic disorder?
With or without agoraphobia
What is the believed underlying etiology of panic disorder?
Elevated norepinephrine, low serotonin and GABA
What is the best treatment option for panic disorder?
SSRIs (paroxetine, sertraline), benzos in the short term
What are the criteria for specific phobias?
Excessive fear, exposure causes immediate anxiety, patient recognizes excessive fear, situation is avoided, duration at least 6 months
What is one effective treatment for performance anxiety?
Beta blockers, paroxetine
What is the DSM criteria for obsession and compulsions?
Obsessions - recurrent intrusive thoughts and impulses, ego syntonic
Compulsions - repetitive behaviors that person does in response to a compulsion
Describe the epidemiology of OCD
More common in those with first degree relative with Tourette's, onset in early adulthood
What is the believed etiology of OCD?
Neurochemical, genetic, psychosocial (triggered by life event)
What is the treatment for OCD?
SSRIs, TCAs, behavioral therapy (exposure and response prevention); last escort cases - ECT
What is the prognosis of OCD?
Lots of substance abuse, depression - only 30% show improvement
What are the diagnostic criteria for PTSD?
Traumatic event, hyperarousal, reexperiencing traumatic event, persistent avoidance for more than a month
What is the recommended treatment for PTSD?
SSRIs, TCAs, MAOIs, cognitive behavioral therapy
What is the DSM criteria for GAD?
Persistent hyperarousal about daily events for at least 6 months
What is the epidemiology of GAD?
Very common (45%), onset usually before age 20, occurs more commonly in women
What is the most effective treatment for GAD?
Antidepressants, psychotherapy, buspirone
How can somatizatiom disorder be distinguished from malingering and conversion disorder?
Conversion and somat. is not volitional- conversion disorder occurs much more rapidly
How do you distinguish a delusion from an obsessive thought?
Patient is aware that thought is silly
What is the usual course of OCD?
Typically relapsing or progressive
A patient presents hearing voices and having large gaps in autobiographical memory. This is..
Dissociative personality disorder
What is the utility of buspirone in anti-anxiety?
Not good for acute anxiety
Child onset OCD is associated with...
What are the two types of somatization disorders?
Primary gain - unconscious against some internal conflict
Secondary - stand to gain something externally
What is derealization?
Occurs during anxiety - sense that what's around you isn't real
What areas of the brain show increased activity on OCD?
Caudate, frontal lobe
What is the neurological correlate of panic disorder?
decreased volume of amygdala
What is the neurological correlate of PTSD?
decreased hippocampus size