Anxiety disorders Flashcards
(39 cards)
What is anxiety
- a normal physiological response to potential threat/ danger
- subjective, unpleasant sense of unease and worry
What is generalised anxiety disorder
excessive and disproportional anxiety, which is not related to a specific event, that negatively impacts the person’s everyday activity
Give 6 key features of anxiety. What is required for diagnosis
Excessive anxiety and worry associated with 3 or more of the following:
* Restlessness
* irritability
* difficulty concentrating
* easily fatigued
* sleep disturbance
* muscle tension
(symptoms present for more days than not for the past 6 months)
Give some physical symptoms of anxiety
- tension headaches
- Sweating
- palpitations and tachycardia
- diarrhoea and nausea
Give 5 secondary causes of anxiety
- hyperthyroidism
- alcohol/ drug abuse
- drug withdrawal
- phaeochromocytoma - tumour of medulla and adrenal glands
- hypoglycaemia
What medications may trigger anxiety
- salbutamol
- theophylline
- corticosteroids
- antidepressants
What questionnaire is used to assess the severity of anxiety
generalised anxiety disorder questionnaire (GAD-7)
Describe GAD-7
7 questions each scored depending on how often the symptoms are experienced.
Describe the step-wise approach to managing generalised anxiety disorder
- education about GAD + active monitoring
- low-intensity psychological interventions (non-facilitated or guided self-help
- high-intensity psychological interventions (CBT) or drug treatment
- highly specialist input e.g. Multi agency teams
What is the drug treatment for managing generalised anxiety disorder
- first line: sertraline
- 2nd line: alternative SSRI or SNRI
- pregabalin if above ineffective/ not tolerated
- propranolol - reduce sympathetic overactivity
- benzodiazepines - only short term/ crisis
What are panic attacks
- sudden onset of intense physical and emotional symptoms of anxiety
- last <20 mins
Features of a panic attack
- physical: dry mouth, palpitations, sweating, SOB
- Emotional: panic, fear, danger, depersonalisation
What is a panic disorder
- unpredictable recurrent panic attacks resulting in worry about further attacks and maladaptive behaviour
- > 4 episodes within one month
How are panic disorders managed
- recognition and diagnosis
- CBT or drug treatment
- Drugs: SSRIs first line, if CI/ ineffective after 12w -> imipramine or clomipramine
What is social phobia
fear of social situations due to preoccupation about being judged negatively by others
What is a phobia
extreme, irrational fear of certain situations/ things causing symptoms of anxiety and panic
Define agoraphobia
- fear of unfamiliar surroundings in which they may be unable to escape if something goes wrong
- avoidance of open air/ crowded spaces
What is post traumatic stress disorder (PTSD)
Condition that may develop following exposure to a traumatic event/ experience
State 4 examples of events that could cause PTSD
- military/ war/ combat
- major health event - heart attack, traumatic childbirth
- violence - SA, domestics, abuse
- natural disasters
Give 3 core features of PTSD
- re-experiencing the event in the present (flashbacks, nightmares)
- deliberate avoidance of triggers
- hyperarousal - hypervigilance, exaggerated startle response
Give 5 additional features of PTSD
- dissociation and depersonalisation
- emotions - anger, shame, depression
- sleep disturbance
- social withdrawal
- suicidality
How long should symptoms be present to make a diagnosis of PTSD
should be present for at least one month
How is PTSD managed psychosocially
- risk assess - others, self (suicide)
- Trauma-focused CBT
- eye movement desensitisation and reprocessing (EMDR) therapy
- support groups
How is PTSD managed pharmacologically
only if adult has a preference for drug Tx or CBT/ EMDR therapy ineffective
* SSRI - sertraline
* SNRI - venlafaxine
* severe cases: risperidone
* <18y - don’t offer meds
