Anxiety disorders: Intro & GAD Flashcards
(32 cards)
Define Neurosis
Psychiatric Disorders characterised by distress
Non Organic with discrete onset
Delusions and Hallucinations are absent
Define Anxiety
Unpleasant Emotional State of subjective fear and somatic symptoms
Define the Yerkes Dodson Law
anxiety can actually be beneficial up to a plateau of optimal functioning. beyond this level of anxiety however, performance deteriorates
Name the ICD10 classifications of Anxiety Disorders
1 - Phobic related disorders
2 - Other Anxiety Disorders (Panic, GAD)
3 - OCD
4 - Reaction to severe stress and adjustment disorder
Name physical symptoms of Anxiety
CVS - Palpitations, chest pain
Resp - Chest Tightness, cough, hyperventilation
GI - Loose Stools, abdominal pain, nausea and vomiting, dysphagia, dry mouth
GU - Increased Micturition Frequency, failure of erection, menstrual discomfort
Neuromuscular - Tremor, myalgia, headache, paraesthesia, tinnitus
Give 5 psychological symptoms of Anxiety
- Impending doom
- Restlessness
- Poor Concentration
- Derealisation
- Depersonalisation
Anxiety can be Paroxysmal or Continuous. Describe Paroxysmal Anxiety.
Situation Dependent - Phobic Anxiety
Situation Independent - Panic Disorder
Anxiety can be Paroxysmal or Continuous. Describe Continuous Anxiety.
GAD
Give 5 conditions related to Anxiety
- Hyperthyroid
- Phaeochromocytoma
- Cushings
- Eating Disorders
- Schizophrenia
Define Generalised Anxiety Disorder
Syndrome of ongoing, uncontrollable widespread worry about many thoughts or events that the patient recognised as excessive and inappropriate.
Symptoms present most days for at least 6 months
Describe the genetic aetiology of Anxiety
5 fold increase if GAD in first degree relative
Describe the neurophysiological causes of GAD
Autonomic Nervous System Dysfunction
Exaggerated activity of Amygdala and Hippocampus
Alterations of GABA/NA/Serotonin
Describe some social risk factors for GAD
Divorced
Single Parent
Low Socioeconomic Status
Domestic Violence
The clinical features of GAD can be remembered by the mnemonic ‘WATCHERS’. Define it
Worry (excessive, uncontrollable)
Autonomic hyperactivity
Tension in muscles
Concentration difficulty
Headache
Energy Loss
Restlessness
Startled easily
Describe the ICD10 diagnostic criteria for GAD
A - Period of at least 6 months of prominent tension, worry, feeling of apprehension
B - Four of the physical symptoms with atleast one being excess autonomic arousal
Describe the expected Appearance, Speech and Mood for a patient with GAD (MSE)
Appearance - worried face with burrowed brow, sweaty
Speech - trembling, slow rate
Mood - Anxious
Describe the expected Thought, Perception, Cognition and Insight for a patient with GAD (MSE)
Thought - Repetitive worrying thoughts
Perception - No Hallucinations
Cognition - Poor memory and reduced concentration
Insight - May or may not have insight
what are some differentials for GAD
other neurotic disorders - panic disorder, specific phobias, OCD, PTSD
depression
schizophrenia
personality disorder
excess caffeine or alcohol
withdrawal from drugs
organic - anaemia, hyperthyroidism, phaeochromocytoma, hypoglycaemia
Name 3 Questionnaires used for GAD
- GAD7
- Becks Depression Inventory
- Hospital anxiety and depression scale
What is the first line management for GAD?
Low Intensity Psychological interventions such as Psychoeducational Groups
What is the Second Line management for GAD?
Combination of CBT and SSRI (Sertraline - continued for at least a year)
Name three other medications that can be used for GAD
SNRIs - Venlafaxine or duloxetine
Pregabalin
Benzodiazepines (Short Term)
Name three social interventions for Generalised Anxiety Disorder
Self Help Methods
Support Groups
Exercise Encouragement
predisposing risk factors for GAD
genetics
childhood upbringing
personality type and demands for high achievement
divorced
living alone or as a single parent
low socioeconomic status
