Panic disorder & Phobia

Question 1

what are panic disorders?

Answer 1

recurrent
unexpected
panic attacks

Question 2

what is a panic attack?

Answer 2

abrupt surge of intense fear or intense discomfort that reaches a peak within minutes

Question 3

F:M ratio for panic attacks

Answer 3

2:1

Question 4

Onset of Panic disorders?

Answer 4

Adolescent

Question 5

Peak of Panic disorders?

Answer 5

Adult

Question 6

is having panic disorder with long remissions possible?

Answer 6

yes

Question 7

Main points on ICD 11 - regarding Panic disorders

Answer 7

• Reccurrent attacks
  -Some physical and autonomic sighs and symptoms
  -Out of the blue (at least some)
  -Fear of recurrence
  -Avoidance of activities or places out of fear of recurrence
  -Not due to anxiety or other mental states
  -Not caused by drugs or other medical conditions
  -Significant Impairment

Question 8

What physical symptoms can be accompany panic attacks

Answer 8

Palpitation
sweating
tinglings
numbing
SoB
Chest pain
Choking sensation
Dizziness
Flushes / chills
Fear of going mad
fear of death
others…

Question 9

difference between panic attacks and real life panics

Answer 9

the former is unexpected

Question 10

NICE recommendation for management of Panic disorder?

Answer 10

• Mild to moderate = self help
  -Severe= CBT or Antidepressants

Question 11

Antidepressants suggested for panic disorder?

Answer 11

SSRI
SNRI
TCAs

Question 12

1st line treatment in panic disorder (NICE)

Answer 12

SSRI or Venlafaxine

Question 13

SSRIs licenced for Panic disorder

Answer 13

Escitalopram
Citalopram
Sertraline
Fluoxetine
Paroxetine
Venlafaxine

Question 14

2nd line of treatment in panic disorder (NICE)

Answer 14

Clomipramine
Imipramine

Question 15

How long you should wait for SSRI effect before changing class?

Answer 15

12 weeks
change it to imi/clomi pramine

Question 16

characteristic of phobia?

Answer 16

fear out of proportion
almost everytime it is confronted

Question 17

onset of phobia

Answer 17

around 10 years

Question 18

specific phobia difference vs situational phobia

Answer 18

the latter happens at a later age

Question 19

when specific phobia’s will probably not remit?

Answer 19

if they persist into adulthood

Question 20

most common subject for specific phobia?

Answer 20

animals 8-6%
heights 6-9%
Storms 3-9%
Water 4%
Flying 3%
Crowds 1-9%

Question 21

most persistent specific phobias at 12 years follow up in ECA (epidemiologic catchment area)

Answer 21

Crowds 28%
Animals 14%
Height 11%

Question 22

most persistent specific phobias at 10 years follow up in NCS (National Comorbidity Survey)

Answer 22

Height 38%
Flying 37%
Closed spaces 34%

Question 23

what is the rate of patients with specific phobia that will receive Rx? why?

Answer 23

1/10
avoiding works for them

Question 24

Rx of chaice for specific phobia?

Answer 24

exposure therapy

Question 25

what unusual Rx are reported to be useful in specific phobia?

Answer 25

D-cycloserine or Glucocorticoids

Question 26

who came up with systematic desensitization?

Answer 26

Wolpe

Question 27

cons of systematic desensitization?

Answer 27

time consuming

Question 28

what did Wolpe think was behind systematic desensitization working?

Answer 28

reciprocal inhibition

Question 29

what did flooding therapy claimed to be working in systematic desensitization?

Answer 29

exposure/subsequent extinctionn

Question 30

what is alternative to flooding therapy, due to it's traumatic nature?

Answer 30

graded exposure