Anxiety and Related Disorders

These flashcards cover key concepts related to anxiety disorders, their symptoms, diagnoses, treatment options, and related disorders to aid in exam preparation.

What are anxiety disorders characterized by?

They are characterized by excessive or inappropriate fear or anxiety.

What is fear manifested by in anxiety disorders?

A transient increase in sympathetic activity, known as the 'fight or flight' response.

How does anxiety differ from fear?

Anxiety involves apprehension regarding the possibility of a negative future event.

What is the DSM-5 classification of anxiety disorders?

It includes generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, selective mutism, and specific phobias.

What factors contribute to the cause of anxiety disorders?

A combination of genetic, biological, environmental, and psychosocial factors.

What are the major neurotransmitters implicated in anxiety disorders?

Norepinephrine (NE), serotonin (5-HT), and gamma-aminobutyric acid (GABA).

What is essential for diagnosing primary anxiety disorders?

Symptoms must NOT be due to the physiological effects of substances, medications, or other medical conditions.

What are some constitutional symptoms of anxiety disorders?

Fatigue, diaphoresis, and shivering.

What cardiac symptoms are associated with anxiety disorders?

Chest pain, palpitations, tachycardia, and hypertension.

What neurological/musculoskeletal symptoms are related to anxiety?

Vertigo, light-headedness, paresthesias, tremors, insomnia, and muscle tension.

What gastrointestinal symptoms can anxiety disorders cause?

Abdominal discomfort, anorexia, nausea, emesis, diarrhea, and constipation.

Which medications and substances can cause anxiety?

Alcohol, sedatives, cannabis, hallucinogens, stimulants, caffeine, tobacco, and opioids.

What medical conditions can cause anxiety symptoms?

Neurologic, endocrine, metabolic, respiratory, and cardiovascular conditions.

What is the lifetime prevalence of panic disorder?

4%.

What is a key feature of panic disorder?

Debilitating anticipatory anxiety about having future panic attacks.

What is a panic attack?

A sudden onset of intense anxiety that may be triggered or occur spontaneously.

What is agoraphobia?

An intense fear of being in public places where escape or obtaining help may be difficult.

What are specific phobias?

Intense fear of a specific object or situation, leading to anxiety or avoidance.

What characterizes social anxiety disorder (social phobia)?

Fear of scrutiny by others or fear of acting in a humiliating way.

What is selective mutism?

Inability to speak in specific social situations despite having the ability to speak in other situations.

What is separation anxiety disorder?

Excessive anxiety regarding separation from attachment figures.

What is the diagnosis and criteria for generalized anxiety disorder (GAD)?

Excessive anxiety/worry about daily events for at least 6 months, with difficulty controlling worry and at least three associated symptoms.

What is the treatment for Generalized Anxiety Disorder?

Combination of psychotherapy (typically CBT) and pharmacotherapy (typically SSRIs) is common.

What characterizes obsessive-compulsive disorder (OCD)?

Experiencing obsessions and/or compulsions that are time-consuming, distressing, and impairing.

What is the lifetime prevalence rate of Obsessive-Compulsive Disorder (OCD)?

2-3%.

What are some common patterns of obsessions and compulsions in OCD?

Contamination, doubt or harm, symmetry, and intrusive taboo thoughts.

What is body dysmorphic disorder?

Preoccupation with perceived defects or flaws in physical appearance that are not observable by others.

What characterizes hoarding disorder?

Persistent difficulty discarding possessions, leading to significant clutter and distress.

What is trichotillomania?

Recurrent hair pulling resulting in hair loss.

What is excoriation (skin-picking) disorder?

Recurrent skin picking resulting in lesions.

What is the main approach for treating trauma and stressor-related disorders?

Utilizing psychotherapy and pharmacotherapy.

What characterizes Posttraumatic Stress Disorder (PTSD)?

Development of intrusive symptoms, avoidance, negative alterations in cognition and mood, and increased arousal after a traumatic event.

What are the first-line medications for PTSD?

SSRIs such as sertraline or SNRIs like venlafaxine.

What differentiates acute stress disorder from PTSD?

Acute stress disorder occurs within one month of the trauma and lasts less than a month.

What treatment is recommended for adjustment disorders?

Supportive psychotherapy, group therapy, and possibly pharmacotherapy.

What are some symptoms of social anxiety disorder?

Fear of public speaking, eating in public, or using public restrooms.

How should SSRIs be initiated for anxiety disorders?

Starting at low doses and increasing slowly due to potential side effects.

What is a common risk factor for panic attacks?

Smoking.

What therapy strategy is effective in treating OCD?

Cognitive-behavioral therapy focusing on exposure and response prevention.

What psychological effect contributes to GAD symptoms?

The worries are free-floating across various areas instead of being fixed.

What is a significant risk factor for developing panic disorder?

Having a first-degree relative with the disorder.

What is the typical age of onset for GAD?

The median age of onset is around 30 years.

What class of medication is commonly used for anxiety?

Selective serotonin reuptake inhibitors (SSRIs).

What behavioral symptoms can accompany separation anxiety disorder?

Extreme distress when separated, excessive worry about harm to attachment figures, and reluctance to be alone.

What psychotherapy is suggested for social anxiety disorder?

Cognitive-behavioral therapy (CBT).

What are the characterizing symptoms of panic disorder?

Recurrent, unexpected panic attacks and persistent fear of future attacks.

What notable feature should be assessed in patients with panic attacks?

Suicidality, due to increased risk.

What is a common symptom reported in body dysmorphic disorder?

Repetitive behaviors aimed at correcting perceived flaws.

What is the typical response of patients with OCD to their symptoms?

They may experience significant distress due to their symptoms.

What is hoarding disorder often accompanied by?

Significant distress or impairment in social and occupational functioning.

How long does it take for SSRIs to typically become fully effective?

About 4-6 weeks.

What should be avoided in PTSD treatment due to high comorbidity with substance use disorders?

Addictive medications like benzodiazepines.

What is a mnemonic to remember GAD symptoms?

Worry WARTS: Wound up, worn-out, Absent-minded, Restless, Tense, Sleepless.

For which type of phobia is CBT with exposure the treatment of choice?

Specific phobias.

What non-addictive anxiolytic alternatives can be considered in patients with comorbid substance use?

Gabapentin and antihistamines like diphenhydramine.

What is the typical response associated with panic attacks?

Dizziness, sweating, palpitations, and intense fear.

What substance withdrawal can cause anxiety symptoms?

Alcohol withdrawal.

What symptoms characterize adjustment disorders?

Emotional or behavioral symptoms that develop within 3 months of a stressor.

What type of therapy is beneficial for selective mutism?

Behavioral therapy, particularly CBT and family therapy.

What is a potential outcome if panic disorder is untreated?

Chronic case with waxing and waning symptoms.

What condition has a significant heritability factor indicated by first-degree relatives being affected?

Agoraphobia.

How long do symptoms need to persist for a diagnosis of obsessive-compulsive disorder?

The symptoms must be time-consuming and cause significant distress.

What treatment may be used for performance anxiety?

Beta-blockers.

What is the relatively rare anxiety disorder characterized by selective refusal to speak?

Selective mutism.

What should always be considered before diagnosing anxiety disorders?

The physiological effects of substances or medical conditions.

Which therapy modality has shown to be effective for PTSD?

Cognitive processing therapy.

What is a common comorbidity with obsessive-compulsive disorder?

Major depressive disorder.

What treatment can be difficult for hoarding disorder?

Specialized CBT for hoarding.

How do panic attacks typically manifest?

Peak within minutes and generally resolve within half an hour.