Lecture 6.1 Flashcards
(35 cards)
What is included in the DSM-5 definition of an “anxiety” disorder?
The DSM-5 definition of an “anxiety” disorder is “anxiety disorder”.
What are the 6 symptoms of generalized anxiety?
The 6 symptoms of generalized anxiety include restlessness, fatigue, concentration impairments, irritability, muscle tension, and sleep disturbances.
For a diagnosis of generalized anxiety, how often must excessive anxiety and worry occur, and over what duration?
For a diagnosis, excessive anxiety and worry (apprehensive expectation) must occur more days than not for at least 6 months, about a number of events or activities.
Besides frequency and duration, what else must anxiety and worry be associated with for a diagnosis of generalized anxiety?
Anxiety and worry must be associated with at least 3 out of 6 symptoms, present for more than not for at least 6 months, and must endorse clinically significant impairment.
What are three conditions that cannot be the cause of anxiety symptoms?
The anxiety symptoms cannot be due to substance use, a diagnosable medical condition, or another psychological disorder.
What does the document suggest about symptom profiles of anxiety, comparing it to depression?
Like depression, there’s substantial heterogeneity in symptom profiles.
What are the two main factors that need to be accounted for when considering heterogeneity in anxiety?
We thus need to account for apprehensive expectation for 6 months or longer, and symptoms needing to happen for 6 months or longer.
What two categories of factors cause heterogeneity in anxiety?
Heterogeneity is caused by the interaction between aetiological factors (genetics / personality traits / environment) and symptoms profiles.
What are some examples of aetiological factors that contribute to heterogeneity in anxiety?
Aetiological factors that contribute to heterogeneity in anxiety include genetics, personality traits, and environment.
What are some significant predictors of poorer prognoses for anxiety?
Significant predictors of poorer prognoses include more severe symptoms experienced for longer, older age, higher neuroticism, unemployment, and physical health issues.
What are the median and mean durations of generalized anxiety?
The median duration is 7.5 months and the mean duration is 15.2 months.
What percentages of individuals did not recover from generalized anxiety at 12 months and 36 months?
8% did not recover at 12 months and 30.1% did not recover even after 36 months.
What are some substances that have been historically used as anxiolytics, dating back to 6000 BC?
The history of anxiolytics includes alcohol (ethanol) from 6000 BC and opium (morphine / codeine) from 1500 BC.
How do barbiturates affect GABA-A receptors?
Barbiturates are positive allosteric modulators of GABA-A receptors.
What are the effects of barbiturates on chloride channel openings and neuronal activity?
They increase the duration of chloride channel openings, leading to a greater influx of chloride ions, which creates an influx of hyperpolarizing neurons, making it less likely to fire an action potential, and also include additional antagonism of NMDA-mediated sodium channels.
What is one of the most widely used barbiturates?
The most widely used was phenobarbital.
Why are barbiturates not considered a specific anxiolytic?
Barbiturates are not a specific anxiolytic, reducing anxiety by virtue of increasing sedation.
What were some of the extreme side effects associated with barbiturates?
Extreme side effects of barbiturates include respiratory depression, reduced inhibition, insomnia, increased sweating, paranoia, mood swings, hallucinations, coma, and brain damage.
Why do barbiturates have limited use today?
They have limited use today with there still being concerns over misuse, as they are extremely addictive, thus with a very high chance of overdose, and often fatal, slowing the heart too much to sustain life.
Why were benzodiazepines created?
Benzodiazepines were created in the 1960s in response to the increasing need for better anxiolytic drugs following dependence and toxicity issues of barbiturates.
What are two examples of benzodiazepines?
Examples of benzodiazepines are chlordiazepoxide (Librium) and diazepam (Valium).
What is the mechanism of action of benzodiazepines?
Benzodiazepine’s mechanism of action is inhibiting neural activity via positive allosteric modulation of GABA-A receptors.
How do benzodiazepines affect chloride ion channels and membranes?
GABA-A receptors pass through ligand-gated chloride ion channels, and when activated they open a chloride channel, allow chloride ions to enter the cell, and hyperpolarize membranes.
What are the major effects of benzodiazepines due to the wide distribution of GABA-A receptors?
As GABA-A receptors are widely distributed, there will be broad inhibitory effects throughout the brain, and there are major effects, including sedation, sleepiness, anticonvulsants, muscle relaxation, and a general reduction of signal transmission.
