Anxiety disorders Flashcards
(23 cards)
What is OCD?
An anxiety disorder characterised by Obsessions and Compulsions
What is an Obsession?
An intrusive thought, unwanted and recurring
The patient has ownership over the thought and recognises it as their own
The patient recognises it is not true
Distressing as they are always egodystonic
What is a Compulsion?
A neutralising behaviour for the stress caused by intrusive thoughts/obsessions. Patient attempts to resist them, finds them pointless
Can be overt or covert
Either not connected or excessive response
What is the difference between a perfectionist and a person with OCD?
Perfectionism is egosyntonic
What is the management of OCD?
Antidepressants eg SSRIs
Patient education
CBT including exposure + response prevention
Define Post traumatic stress disorder
Exposure to an event/situation of catastrophic nature which would likely cause distress in the majority of the population causing intrusive memories/flashbacks within 6 months of the event
What are the 3 main features of post traumatic stress disorder?
Re-experiencing Avoidance Hyperarousal Dissociation *May also be irritable or have poor concentration*
What is the treatment for PTSD?
Psychotherapy CBT Eye movement desensitisation and reprocessing (EMDR) Group therapy Antidepressants
What features make anxiety pathological?
Excessive for situation
Persists in absence of real threat
Impairs social functioning
What are the psychological symptoms of anxiety?
Hyper arousal Worry Recurrent thoughts of impending doom Inability to concentrate Irritability
What are the biological symptoms of anxiety?
Sympathetic activation/autonomic arousal eg tachycardia, sweating, increased BP
Muscle tension
What are some of the physical conditions that can cause anxiety? THINC MED
Tumours eg phaechromocytoma Hyperthyroidism Infections eg lyme disease Nutrients eg B12 deficiency CNS eg head trauma Miscellaneous eg Wilson's disease Electrolyte imbalances/environmental toxins eg Hyperkalaemia/Organophosphates Medications eg Cocaine, alcohol withdrawal, steroids, metoclopramide
What are the primary anxiety disorders? (7)
Agoraphobia Panic disorder Social phobia Specific phobia Generalised anxiety disorder PTSD OCD
What is Panic disorder?
Recurrent unexpected surges of severe anxiety
Anticipating panic attacks between episodes - persistent concern, Worry about consequences of another attack, sig change in behaviour relating to attack
What is the treatment for Panic disorder?
SSRIs Short term benzodiazepines SNRIs NASAs TCAs CBT
Define Agoraphobia
Fear in places/situations where exit may be difficult or where help may not be available eg being in a crowd, being on public transport, being outside the home (2 needed for ICD-10)
Situations either avoided or endured with severe psychological stress
What is the treatment of Agoraphobia?
Patients with Agoraphobia often have panic disorder (+visera versa)
SSRIs
SNRIs/TCAs
CBT
Define Generalised anxiety disorder
Free floating persistent, excessive + inappropriate worry. Patient finds it difficult to control symptoms
What is the treatment for GAD?
SSRIs eg Sertraline SNRIs eg Venlafaxine BDZs short term TCAs Anxiolytics eg Buspirone CBT
Define Social phobia
Marked, persistent and unreasonable fear of either;
Being judged in social/performance situations
Humiliating oneself in social/performance situations
Avoided or endured with significant personal distress
Person recognises fear as unreasonable and excessive
What is the treatment of Social phobia?
SSRIs SNRIs BDZs short term Gabapentin, Pregabalin Olanzipine CBT
Define Specific phobia
Excessive or unreasonable fear of a specific thing eg spiders, flying, specific people
Avoided or endured with significant personal distress
What is the treatment of Specific phobia?
CBT/Exposure techniques
SSRIs
