PSYCHIATRY > Anxiety > Flashcards

Anxiety Flashcards

(43 cards)

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1
Q

Give examples of the biological symptoms of anxiety.

A
  • Sweating, hot flushes or cold chills
  • Trembling
  • Muscle tension/aches/pains
  • Numbness or tingling sensations
  • Feeling dizzy, unsteady, faint or lightheaded
  • Dry mouth (not due to medication or dehydration)
  • Feeling of choking
  • Lump in the throat, or difficulty in swallowing
  • Difficulty breathing
  • Palpitations
  • Chest pain
  • Nausea /churning in stomach
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2
Q

Give examples of the cognitive symptoms caused by anxiety

A
  • Fear of losing control
  • Difficulty concentrating, “mind going blank”
  • Feeling that objects are unreal - derealization
  • Feeling that the self is distant - depersonalisation
  • Hypervigilance (internal and external)
  • Racing thoughts
  • Meta-worry
  • Health anxiety
  • Preference for order and routine
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3
Q

What behavioural symptoms indicate anxiety?

A
  • Avoidance of situations
  • Exaggerated response to minor surprises/startled
  • Difficulty sleeping due to worrying
  • Excessive use of alcohol/drugs
  • Restlessness/ irritability
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4
Q

Acute stress increases cortisol levels. TRUE/FALSE?

A

TRUE

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5
Q

When is anxiety considered pathological?

A
  • when anxiety is more extreme than “normal”

- when anxiety presents in certain situations that are not “normally” anxiety provoking

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6
Q

Give examples of types of anxiety disorder?

A 
Generalised Anxiety Disorder
Panic Disorder
Agoraphobia
Social Phobia
Specific Phobia
Obsessive Compulsive Disorder
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7
Q

What is meant by Generalised Anxiety Disorder?

A
  • generalised and persistent anxiety
  • not in any particular circumstance or environment
  • long-lasting (most days for at least 6 months)
  • not controllable
  • causing significant distress / impairment in function
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8
Q

What symptoms of anxiety are typically found in Generalised Anxiety Disorder?

A
  • restlessness
  • easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance
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9
Q

Who normally gets Generalised Anxiety Disorder?

A

Typical age of onset between 20-40

2:1 female:male ratio

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10
Q

What percentage of patient’s with Generalised Anxiety disorder also have other co-morbid psychiatric disorders (e.g. depression, substance abuse etc)

A

90%

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11
Q

How is generalised anxiety disorder treated?

A
  • Cognitive Behavioural Therapy
  • SSRIs / SNRIs
  • Pregabalin
  • Benzodiazepines (short term only)
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12
Q

What is CBT and how does it work?

A
  • Talking therapy
  • identifying individual’s automatic thoughts, cognitive biases and schemas
  • Help the individual understand why their thoughts are pathological/harmful and perpetuate the anxiety
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13
Q

What is panic disorder?

A
  • recurrent attacks of severe anxiety
  • not restricted to any particular situation
  • unpredictable
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14
Q

What symptoms and thoughts are experienced in a panic disorder?

A

palpitations
chest pain
choking sensations
dizziness
feelings of unreality (depersonalization or derealization)
Secondary fear of dying/losing control/going mad

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15
Q

Many patients with panic disorder also have agoraphobia. TRUE/FALSE?

A

TRUE

50-67%

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16
Q

When is the typical onset of panic disorder?

A

Late adolescence to mid-30’s

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17
Q

How many people have recovered or improved at 10 year follow up of a panic disorder?

A

1/3 unchanged or worse
1/3 modest improvement
1/3 well

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18
Q

How are panic disorders treated?

Study These Flashcards
A

Cognitive Behavioural Therapy
SSRIs / SNRIs / Tricyclics

Benzodiazepines (short term only)

19
Q

When do phobias typically present?

Study These Flashcards
A
  • Agoraphobia = 20-30s

- Social and Specific phobias = early adolescence - early 20’s

20
Q

Do patients with a phobia recognise their fear is irrational?

21
Q

What is agoraphobia?

Study These Flashcards
A

cluster of phobias:

  • fears of leaving home
  • entering shops
  • crowds
  • public places
  • Travelling alone in trains, buses or planes
22
Q

Sometimes patients with agoraphobia can avoid their stimulus so much that they experience very little anxiety. TRUE/FALSE?

23
Q

What are the signs of agoraphobia in relation to shopping?

Study These Flashcards
A

others do shopping (for or with the patient)
go shopping to 24 hour store at night (when quiet)
Internet shopping!

24
Q

Why do patients with agoraphobia often drink alcohol?

Study These Flashcards
A
  • to overcome fear and allow them to go out and do tasks they wouldn’t previously do
25
Give examples of specific phobias
flying, heights, animals or insects, receiving an injection or seeing blood
26
How are specific phobias treated?
Behavioural Therapy – exposure Graded exposure / systematic desensitisation Add in CBT if necessary SSRIs / SNRIs if required
27
What is social phobia/social anxiety disorder?
- persistent fear where person is exposed to unfamiliar people or to scrutiny by others - fears that he or she will act in a way that will be embarrassing and humiliating
28
Social phobia can cause problems with poor school performance. TRUE/FALSE?
TRUE school refusal causes poorer results may cause poor employment
29
How is social phobia treated?
Cognitive Behavioural Therapy SSRIs / SNRIs Benzodiazepines (short term only)
30
What type of thoughts are typical of OCD?
Ego-dystonic | => thoughts that are distressing/ unacceptable or inconsistent with one's self-concept.
31
What is meant by the "compulsive acts" involved in OCD?
- Repeated rituals or stereotyped behaviours - Not enjoyable/ pointless acts - Often viewed as “neutralising” aka will stop something bad from happening
32
How is OCD diagnosed?
Obsessive symptoms/ compulsive acts present most days for at least 2 weeks AND these are source of distress and interference with activities
33
Name some of the common obsessions associated with OCD?
Contamination Fear of Harm Concern with order/symmetry
34
Name some of the common compulsive acts of OCD?
Checking cleaning/washing repeating acts
35
When is the typical onset of OCD?
mean age of onset – 20 peak incidence for males – 13-15 peak incidence for females – 24-25
36
What percantage of OCD patients experience at least 1 depressive episode?
60-90%
37
What comorbidities (other psychiatric conditions) can accompany OCD?
schizophrenia Tourettes and other tic disorders Body dysmorphic disorder Eating disorders
38
How is OCD treated?
Cognitive Behavioural Therapy Including response prevention SSRIs / Clomipramine
39
HOw do benzodiazepines help to treat anxiety
``` Bind to GABA-A receptor Allow Chlordie ion influx Membrane hyperpolarisation => NO AP generated and neurons dont fire ```
40
What problems can occur with benzodiazepines if they are used for longer than 2 weeks?
- Sedation and psychomotor impairment - withdrawal problems - Dependency and abuse - Alcohol interaction - Can worsen co-morbid depression
41
What type of medication is first line in OCD?
SSRI
42
OCD is highly comorbid with other disorders. TRUE/FALSE?
TRUE
43
What is the difference between obsessive thoughts and mental compulsions?
Mental compulsions involve patient role-playing their compulsion in their head => i.e. counting to certain number, imagining they are completing a task etc
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