Wk 27 - Anxiety 1 Flashcards

1
Q

What is anxiety?

A
  • Normal response to threat or danger

- Mental health problem if response exaggerated, lasts more than 3 wks + interferes w/ daily life

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2
Q

What is anxiety characterised by?

A
  • Worry + agitation
  • Rapid breathing
  • Fast heart beat
  • Sweats
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3
Q

What are symptoms of anxiety?

A
  • Goosebumps
  • Muscles tense
  • HR inc
  • Pupils dilate
  • Terror
  • Anticipate harm
  • Avoidance
  • Dec appetite
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4
Q

What is generalised anxiety disorder characterised by?

A
  • Excessive + inappropriate worrying that is persistent

- Comorbid w/ depression, panic disorder, phobia + OCD

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5
Q

What is panic disorder characterised by?

A
  • Recurrent unexpected surges of severe anxiety w/ anticipatory anxiety
  • Panic attack peak w/in 10mins + last 45 mins
  • Develop fear of further panic attacks
  • 2/3 develop agoraphobia
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6
Q

What is agoraphobia?

A

Fear in places or situation where escape is difficult or not available in event of panic attack

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7
Q

What is social phobia characterised by?

A
  • Marked, persistent + unreasonable fear of being observed or evaluated negatively by other people in social situations
  • Associated w/ physical + psychological anxiety symptoms
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8
Q

What is specific phobia characterised by?

A
  • Excessive or unreasonable fear of single people, animal, objects or situations avoided or endured w/ significant personal distress
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9
Q

What is PTSD characterised by?

A
  • History of exposure to trauma w/ response of intense fear
  • W/ later development of re-experiencing symptoms, avoidance symptoms + hyperarousal symptoms
  • W/in 6 months of exposure to trauma
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10
Q

What is OCD characterised by?

A

Mental health condition where you have recurring thoughts + repetitive behaviours that you cannot control

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11
Q

Based on NICE guidelines, what is step 1 of anxiety disorders?

A

Identification:

  • Identify + communicate diagnosis of GAD early
  • Consider diagnosis if presenting w/ worry or attend primary frequently bc of chronic physical health problems/somatic symptoms
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12
Q

After step 1 identification, what happens?

A

Education, treatment + monitoring:

  • Provide education about GAD + options for treatment
  • Monitor symptoms + functioning
  • Discuss OTC med
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13
Q

Based on NICE guidelines, what is step 2 of anxiety disorders?

A

Low intensity treatment

  • For GAD that has not improved after education + active monitoring in step 1
  • Individual non-facilitated self-help
  • Individual guided self-help
  • Psychoeducational groups
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14
Q

Based on NICE guidelines, what is step 3 of anxiety disorders?

A

High-intensity treatment

  • For GAD w/ marked functional impairment or not improved after step 2
  • CBT or applied relaxation or drug treatment using SSRI
  • Don’t offer antipsychotic
  • Don’t offer benzodiazepines as ST
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15
Q

What happens if the patient has inadequate response to step 3 interventions?

A

Not responded to:

  • High intensity psychological intervention - offer drug treatment
  • Drug treatment - high intensity psychological intervention or alternative drug treatment
  • Partially responded - high intensity psychological intervention in addition to drug
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16
Q

When is referral to step 4 required?

A
  • Severe anxiety + marked functional impairment
  • Risk of self-harm + suicide
  • Significant co-morbidity
  • Self-neglect
  • Inadequate response to step 3 interventions
17
Q

Based on NICE guidelines, what is step 4 of anxiety disorders?

A

Highly specialist treatment

  • Psychological + drug treatment
  • Antidepressant combination
  • Augmentation of antidepressant w/ other drugs
18
Q

Outline the biological basis of anxiety

A
  • Dec 5-HT NT
  • NA systems overactivity
  • Deficient inhibition of GABA interneurons w/ red sensitivity to postsynaptic GABAA receptors
  • Excessive activity of glutamate neurons at NMDA receptors in amygdala (fear conditioning)
  • Super sensitivity of receptors for peptide NT (cholecystokinin + neuropeptide Y)