Anxiety Disorders

Question 1

NT’s involved in anxiety disorders

Answer 1

GABA, glutamine, serotonin, NE

Question 2

GAD Dx

Answer 2

“worry” for at least 6 months- causes impairment, distress, deviance. not able to be controlled. also sleep problems, irritable, easily fatigued, poor conc, restless

Question 3

onset GAD

Answer 3

mostly women in 20-30’s homemakers, unemployed

Question 4

what disorder has lowest inter-rater reliability of all anxiety disorders?

Answer 4

GAD

Question 5

what disorder has highest rate of comorbidity with depression and other anxiety disorders?

Answer 5

GAD

Question 6

Tx of GAD

Answer 6

antidepressants- SSRI, SNRI, Buspirone, mirtazepine, tricyclics. time management, goals, relaxation, meditation, exercise, CBT

Question 7

agoraphobia

Answer 7

anxiety about or avoiding places or situations from which escape might be difficult or embarassing (on train, or plane)- can cause complete avoidance of these places

Question 8

panic attack peak and duration

Answer 8

peaks within 10 minutes, duration 5-20 minutes

Question 9

sudden onset of fearfullness, terror, impending doom. urgent desire to flee. palpitations, sweating, shaking, SOB, derealization, fear of going crazy or dying, chext pain, chills, hot flashes…

Answer 9

panic attack (not diagnosis..is symptom)

Question 10

genetics in panic disorder

Answer 10

41% risk in identical twins

Question 11

etiology of panic disorder

Answer 11

GABA abnormality, increased catecholamines, abnormality of locus coeruleus, carbon dioxide hypersensitivity, lactate metabolism disturbance

Question 12

suicide attempt in PD

Answer 12

up to 20%

Question 13

tx for PD

Answer 13

benzo for short term- monitor for addiction, and SSRI, SNRI- takes up to 2 months to get therapeutic. Add CBT. relaxation, cogniitive therapy, exposure therapy

Question 14

If SSRI/SNRI, cbt not helpful with benzo consider

Answer 14

MAOI, mood stabilizers

Question 15

tx for specific phobia

Answer 15

exposure therapy or avoidance

Question 16

somatic complaints of SAD

Answer 16

stuttering, blushing, sweating, palpitations, flushing, trembling, butterflies

Question 17

to screen for SAD

Answer 17

MINI-spin screen

Question 18

tx for SAD

Answer 18

ssri, benzo in certain settings. CBT. consider BB only for public speaking.

Question 19

genetics in OCD

Answer 19

parent with OCD increases risk tenfold

Question 20

M and W OCD prevalence

Answer 20

Boys to girls 3;1. But equal in men and women

Question 21

comorbidities with OCD

Answer 21

50-90% of patients with tourette’s have OCD. Over 50% of patients with OCD have personality disorder (avoidant or dependent most commonly)

Question 22

which type of personality disorder in OCD worsens prognosis?

Answer 22

schizotypal

Question 23

tx for ocd

Answer 23

doc are ssri’s. 6-10 weeks at max dose. 80% have reduced symptoms at 5 months

Question 24

important to screen for this in PTSD

Answer 24

potential substance abuse