Generalised Anxiety Disorder Flashcards
Definition of GAD
Excessive worry about every day issues disproportionate to any inherent risk
Risk factors of GAD - 5
- female sex
- other anxiety disorders e.g. panic or social phobia
- FH
- Childhood adversity
- Social factors
Associated symptoms of GAD - 4
Lots present solely with physical symptoms:
- headaches
- GI symptoms
- Insomnia
- backpain
- restlessness/ on edge
- difficulty concentrating
- irritable
- sleep disturbance
How is GAD diagnosed - 5
1) suspect if a pt reports chronic worry not related to any circumstance.
2) Use diagnostic criteria which states GAD is:
- excessive anxiety and worry for at least 6 mths
- its difficult to control the worry
- They have associated symptoms
- Anxiety is causing significant distress and impairig pts life
3) Use GAD-7 questionnair to determine severity
4) Assess suicide risk
5) Physical examination - may have high HR, SOB, Trembling
Which medications have side effects of anxiety - 6 (stabss)
- Salbutamol
- Theophylline
- Beta Blockers
- St Johns Wort
- Corticosteroids
- Antidepressants
Differentials of GAD - 11
- Situational anxiety
- Depression
- Panic disorder (panic attacks)
- OCD
- Social Anxiety
- PTSD
- Anorexia nervosa
- Substance abuse withdrawl
- Cardiac disease
- IBS
- Hyperthyroidism
Describe the GAD-7 questionnaire and what results mean
Consists of 7 questions where you score a maximum of 21
5-10 - mild GAD
10-15 - Moderate
15-21 - Severe
Describe Step 1 of the 3 step management approach to GAD - 2
- provide info about GAD and direct to resources
- araange active monitoring
Describe Step 2 of the 3 step management approach to GAD - 2
- Individual self help. Suitable written materials that the pt works through alone for 6 weeks. Supported by a therapist
- Psychoeducational groups
Describe Step 3 of the 3 step management approach to GAD -
- CBT
- Drug treatment:
1st line - sertraline (SSRI)
2nd line - other SSRI or SNRI
3rd line - pregabalin (a GABA agonist)
