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Psychiatry > Anxiety Disorders > Flashcards

Anxiety Disorders Flashcards

1
Q

What is generalised anxiety disorder?

A

Symptoms of anxiety occurring persistently (>6 months), with symptoms not confined to a specific situation or object

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2
Q

What sex is generalised anxiety disorder most common in?

A

F>M

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3
Q

What are the 5 classifications of anxiety symptoms?

A

Psychological arousal

Autonomic arousal

Muscle tension

Hyperventilation

Sleep disturbance

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4
Q

Give psychological arousal symptoms of anxiety

A

Fearful anticipation

Irritability

Sensitivity to noise

Poor concentration

Worrying thoughts

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5
Q

Give GI autonomic arousal symptoms of anxiety

A

Dry mouth

Swallowing difficulties

Dyspepsia

Nausea

Wind

Frequent loose motions

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6
Q

Give respiratory autonomic arousal symptoms of anxiety

A

Tight chest

Difficulty inhaling

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7
Q

Give cardiovascular autonomic arousal symptoms

A

Palpitations

Missed beats

Chest pain

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8
Q

Give genitourinary autonomic arousal symptoms

A

Frequency/urgency of micturition

Amenorrhoea

Dysmenorrhea

Erectile failure

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9
Q

Give CNS autonomic arousal symptoms of anxiety

A

Dizziness

Sweating

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10
Q

Give the muscle tension symptoms of anxiety

A

Tremor

Headache

Muscle pain

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11
Q

Give the hyperventillation symptoms of anxiety

A

Causing CO2deficit e.g. hypocapnia

Numbness tingling in extremities may lead to carpopedal spasm

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12
Q

Give the sleep disturbance symptoms of anxiety

A

Initial insomnia

Frequent waking

Nightmares and night terrors

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13
Q

What are the psychiatric differential diagnoses of generalised anxiety disorder?

A

Depression

Schizophrenia

Dementia

Substance misuse

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14
Q

What are the physical differential diagnoses of generalised anxiety disorder?

A

Thyrotoxicosis

Pheochromocytoma

Hypoglycaemia

Asthma

Arrhythmia’s

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15
Q

What is the low-intensity management of generalised anxiety disorder?

A

Counselling

  • Clear plan of management
  • Explanation and management
  • Avoid caffeine, alcohol and exercise

Relaxation training

  • Group or individual, DVD, tapes or clinician led

Symptomatic Relief

  • B Blockers
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16
Q

What is the high-intensity management of generalised anxiety disorder?

A

Cognitive behavioural therapy

Antidepressants

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17
Q

What is obsessive compulsive disorder (OCD)?

A

Recurrent obsessional thoughts and/or compulsive acts present on most days for at least two successive weeks, causing distress or interference with daily activities

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18
Q

What sex is OCD more common in?

A

M=F

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19
Q

What are obsessional thoughts?

A

Intrusive thoughts/images that are unpleasant and distressing, inconsistent with their typical views and values, but recognised as their own thoughts

20
Q

What are compulsive acts?

A

Repeated and pointless behaviours/rituals to prevent anxiety

21
Q

What are overt compulsions?

A

Repeating something physically

22
Q

What are covert compulsions?

A

Repeating something mentally

23
Q

How is OCD managed?

A

General measures

  • Education and explanation
  • Involve partner/family

Cognitive behaviour therapy

  • Exposure and response prevention
  • Examination of evidence to weaken convictions

SSRI

Psychosurgery

24
Q

Give differential diagnoses of OCD

A

Depression

Obsessive compulsive personality disorder

Tourette’s syndrome

Schizophrenia

25
Q

What is post traumatic stress disorder?

A

Delayed and/or protracted reaction to a stressor of exceptional severity (would distress anyone), after 4 weeks of the event

26
Q

What sex is PTSD most common?

A

F>M

2:1

27
Q

What events can cause PTSD?

A

Combat

Natural or human-caused disaster

Rape

Assault

Torture

Witnessing any of the above

28
Q

What vulnerability factors can increase the risk of PTSD?

A

Mood disorder

Previous trauma especially as child

Lack of social support

Female

29
Q

What protective factors can decrease the risk of PTSD?

A

Higher education

Social group

Good paternal relationship

Susceptibility partly genetic

30
Q

What are the 3 key elements to a PTSD reaction?

A

Hyper-arousal

Re-experiencing a phenomena

Avoidance of reminders

31
Q

Give hyper-arousal symptoms of PTSD

A

Persistent anxiety

Irritability

Insomnia

Poor concentration

32
Q

Give the re-experiencing symptoms of PTSD

A

Intensive intrusive images

Flashbacks when awake

Nightmares during sleep

33
Q

Give the avoidance symptoms of PTSD

A

Emotional numbness

Cue avoidance

Recall difficulties

Diminishes interests

34
Q

How is PTSD managed?

A

Survivors of disasters screened at one month

Mild symptoms ‘watchful waiting’ and review further month

Trauma-focused CBT if more severe symptoms

Eye movement desensitisation and reprocessing

Risk of dependence with any sedatives but patient may prefer medication e.g. SSRI or TCA

35
Q

What can cause phobic anxiety disorder?

A

Genetics

Psychological factors and life events

Premorbid personality: Shyness in social phobia

Comorbid anxiety disorders, depression, substance misuse, OCD

36
Q

Give types of phobic anxiety disorders?

A

Agoraphobia

Specific phobias

Social phobia

37
Q

What is agoraphobia?

A

Fear of leaving home, where escaping would be difficult

38
Q

What is social phobia?

A

Inappropriate anxiety in situation where person feels observed or could be criticised (restaurants, shops, queues, public speaking)

39
Q

How does phobic anxiety disorder present?

A

Phobic avoidance

Anticipatory anxiety

Same core features as GAD

Blushing tremor: Social phobia

40
Q

What is panic disorder?

A

Recurrent unforeseen panic attacks followed by at least a month of worrying of another attack

41
Q

What is a panic attack?

A

Recurrent unpredictable attacks of severe anxiety, reaching intense fear and panic within 10 minutes

42
Q

How do panic attacks present?

A

Palpitations

Sweating

Tremors

SOB

Choking sensation

Impending doom

Dizziness

Nausea

43
Q

Give causes of generalised anxiety disorder?

A

Genetic predisposition

Anxious-avoidant personality trait

Co-morbid depressive disorder

Traumatic life experiences

Chronic health condition

History of alcohol dependence

History of substance misuse

44
Q

What is the first line therapy for OCD?

A

Exposure and response prevention

45
Q

What is acute stress reaction/disorder?

A

GAD symptoms that occur int he first 4 weeks of being exposed to a stressful or traumatic event

46
Q

How is acute stress disorder managed?

A

Trauma-focused cognitive-behavioural therapy (CBT)

Benzodiazepines

  • Used with caution for acute symptoms

Psychiatry (11 decks)

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