anxiety disorders Flashcards

1
Q

is the emotional (and physiological) response to an imminent threat.

A

fear

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2
Q

is the anticipation, or worry/preoccupation with a future threat.

A

anxiety

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3
Q

Recurrent distress when anticipating or experiencing separation

Persistent and excessive worry about separation and/or harm/illness that will result to them as a result

Affects daily functioning, going to school, work, leaving the house, fear of being alone

A

Separation Anxiety Disorder

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4
Q

what symptoms present with separation anxiety

A

Recurrent physical symptoms when separation is imminent, recurrent nightmares

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5
Q

how long must symptoms be present for in separation anxiety

A

In children and adolescents, 4 weeks of symptoms, in adults 6 months or more

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6
Q

what is the cause of separation anxiety in kids

adults?

A

Usually parent is the focus for children,

in adults usually spouse or a friend

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7
Q

what is normal separation anxiety

A

experienced by babies. This is normal stage of development that begins around 9 months of age.

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8
Q

how may separation anxiety present in school aged kids

A

In pre-school/grade school may manifest as “illnesses” keeping the child at home or sneaking away from school to return home

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9
Q

Irrational, excessive fear of objects, places, situations

Must last at least 6 months (not transient)

A

Specific Phobia Disorder

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10
Q

Fear of humiliation or embarrassment in social settings, being observed by other people

A

Social anxiety disorder (SAD)

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11
Q

Specific Phobias & Social Anxiety Disorder tx

A
approved medications for  SAD include: 
fluoxetine, 
paroxetine, 
sertraline (SSRIs) 
and venlafaxine (SSNRI)

MAOIs and benzodiazepines are also effective but first-line med have better side effect profiles

Beta-blockers are effective for short-term treatment of performance anxiety but not effective for SAD

Behavior therapy including exposure and flooding therapy has been shown to be very effective for both specific phobias and SAD

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12
Q

is medication effective for specific phobias

A

no

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13
Q

t/f Both specific phobias and SAD run in families;

A

true, Blend of genetics and learning most likely.

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14
Q

a collection of symptoms
They are not diagnosable as a discrete mental disorder

can occur in many different psychiatric conditions

usually begin suddenly and attacks usually peak in 10 minutes

A

Panic attacks

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15
Q

how long do most panic attacks last

A

Most last somewhere from 5-20 minutes

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16
Q

may cause generalized fear reactions to multiple things associated with social situations - starts as eating in a restaurant, then standing in line, then using public bathroom, then won’t go out at all

A

Social anxiety disorder (SAD)

17
Q

Recurrent, unexpected panic attacks with at least 1 month of worry about having more panic attacks

Must have 4 of the 13 symptoms for a panic attack

Many of these symptoms could also be indicative of a serious medical condition

A

Panic Disorder

18
Q

common comorbities that go with panic disorder

A

Major depression and alcohol use disorder are the most common psychiatric comorbidities

19
Q

common age for panic disorder

A

before age 30, mid-20s is when most patients present

20
Q

panic disorder tx

A

Medication in conjunction with psychotherapy

fluoxetine,
paroxetine,
sertraline
and venlafaxine

Cognitive behavioral therapy should also be employed, specifically Panic Control Therapy (PCT)

21
Q

what must you rule out for panic disorder

A

hyperthyroidism, pheochromocytoma, hypoglycemia, SVT, angina, etc.

22
Q

Worry excessively about life circumstances (job, health, finances, relationships)

Rates are higher in women and those under 30

The disorder is usually chronic with fluctuation in the severity of the symptoms

A

Generalized Anxiety Disorder

23
Q

GAD tx

A

Combined therapy is best

Cognitive behavioral therapy is the mainstay for therapeutic treatment

paroxetine,
escitalopram,
venlafaxine
and buspirone

Pure behavior therapies include: relaxation training, re-breathing exercises, meditation

24
Q

comorbities in GAD

A

substance use and major depression are common comorbidities

25
Q

Compulsions occur to distract or relieve anxiety the patient feels due to their obsessions

obsession/compulsions are very time consuming or cause significant distress

A

obsessive compulsive disorder

26
Q

are repetitive and intentional, and highly stereotyped/rigid

A

Compulsions

27
Q

intrusive thoughts

A

obsessions

28
Q

marker for OCD prognosis

A

Whether or not a patient has insight into their condition is a marker for prognosis

29
Q

t/f of oc disorder

Most patients will suffer a chronic course (85%), a smaller percentage will have a deteriorating course (10%)
Patient usually report worsening symptoms when they are stressed

A

true

30
Q

OC disorder age of onset

A

OC Disorder typically begins in late teens to early 20s

31
Q

t/f OC disorder Onset is gradual to sudden

equal in male and females but males tend to present slightly earlier

A

true

32
Q

t/f 70-80% of patient with OC disorder will not have recurrent major depression

A

false they do

33
Q

OCD occurs more frequently in people with what?

A

neurological disorders like epilepsy, Sydenham’s chorea, Huntington’s disease and thus a neurobiological basis is likely.

34
Q

Obsessive Compulsive Disorder tx

A

Medication and cognitive behavior therapy

SSRIs
fluoxetine,
paroxetine
and sertraline

Other classes of anti-depressants have not been effective

The effective dosage, however, is about 2x as that used for depression and it may take 3-4 months to have a clear effect

35
Q

is the mainstay of tx for OC disorder

A

CBT is the mainstay, specifically Exposure and Response Prevention (ERP) therapy

36
Q

t/f oc disorder and tourette’s are the same disorder

A

false they are not

but occur together often