Anxiety And Eating Disorders Flashcards

Question

Psychological management of anxiety

Answer 1

CBT is first line Identify and challenge cognitive biases such as catastrophic thinking, and recognise learnt behaviours based upon such biases Relaxation therapy can also be used

Answer 2

SSRIs - 1st line for moderate severe symptoms only - 2nd line is an alternate SSRI, or SNRI - drugs generally take longer to work and need to be titration to higher doses to be effective in anxiety disorders Benzodiazepines - potentiate GABA - effective in rapidly reducing anxiety symptoms - rapid tolerance and dependence syndrome so avoided where possible Non selective beta blockers - can be used prn to dampen symptoms of autonomic arousal

Answer 3

Ensure social support structures are in place Reduce alcohol / illicit drug use

Answer 4

Chronic, fluctuating course

Answer 5

An intense, irrational fear of an activity or situation

Answer 6

Prevalence of all phobias is around 8%

Answer 7

Specific phobias can often be traced back to childhood exposures - genetic predisposition for some objects to evoke fear and behavioural conditioning can re-enforce this fear Agoraphobia and social phobias are poorly understood All involve some level of amygdala dysregulation

Answer 8

Intense symptoms of anxiety related to a discernible object / situation Can manifest as panic attacks at their most severe

Answer 9

Fear of public places (crowds, queues, public transport) Can become housebound Classically a fear of a lack of a clear exit More common in females

Answer 10

Fear of social situations in which they may be exposed to scrutiny eg fear of eating in public Can progress to almost all social situations - patients describe fear of going mad or vomiting in public More commonly seen in males (most comfortable when alone) Linked to alcohol abuse

Answer 11

1st line is psychotherapy (CBT) - involved graded exposure (desensitisation) SSRIs can be useful for agoraphobia / social phobia Benzodiazepines are occasionally used for rarely occurring situations eg flying

Answer 12

Specific phobias held from childhood are unlikely to remit Social phobias are usually chronic but may have periods of remission

Answer 13

- involuntary thoughts, images or impulses that are recurrent, intrusive and unpleasant - enter the mind against conscious resistance and are recognised as being the produce of their own mind - patients generally have insight into the fact that the thoughts are irrational

Answer 14

Repetitive mental operations eg counting, praying or physical acts eg checking, hand washing - patient feels compelled to perform this act in response to their own obsessions or irrationally defined rules The acts are performed to reduce anxiety through the belief that they will stop a dreaded event from occurring Resisting a compulsion can lead to increased anxiety

Answer 15

Epi: prevalence of 2%, equal M:F Aeti: genetic predisposition to develop symptoms Symptoms common in childhood Mean time from onset of symptoms to diagnosis is 9yrs

Answer 16

Schizophrenia, Tourette’s or depression

Answer 17

1. Damage to the cortico-striato-thalamo-cortical circuits following neurological injury eg stroke can invoke symptoms of OCD 2. Neurosurgical interruption of these circuits has also been shown to induce response in OCD patients resistant to all other treatments

Answer 18

Obsessions or compulsions present for at least 2 successive weeks Source of distress and / or interfere with the patients functioning They are acknowledged as coming from the patients own mind Obsessions are unpleasantly repetitive At least one thought / act is resisted unsuccessfully A compulsive act is not in itself pleasurable

Answer 19

CBT is 1st line, involving exposure response prevention Aims to break the cycle of behaviour by exposing the patient to their obsession but preventing the compulsive response

Answer 20

SSRIs considered for moderate - severe symptoms

Answer 21

Optimise social support structures, screen for substance abuse

Answer 22

Mainly chronic fluctuating course, with around 15% showing a progressive decline in functioning

Answer 23

Most common in children and adolescents but can happen in any age Around 1% prevalence equal M:F More common in those with mental health history and low social support

Answer 24

- maladaptive reaction to psychosocial stressors, causing an impairment of function - must develop within 3 months of a stressful life event - symptoms do not generally last >6 months

Answer 25

Acute stress disorder is an acute stress reaction that occurs in the 4 weeks after a traumatic event as opposed to PTSD which is diagnosed after 4 weeks

Anxiety And Eating Disorders Flashcards

(49 cards)