Anxiety Disorders & Somatic-symptom Related Disorder

how is separation anxiety diagnosed?

at least 3 of 7 criteria for at least 4 weeks for >6 months

how is a panic attack diagnosed?

4+ symptoms ex. palpitations, sweating, trembling, chest pain

how is panic disorder diagnosed?

must be at least one attack followed by one month or more of persistent concern or changed behavior related to the attacks

what will 40% of pts w/ panic disorder experience?

severe depression

what is the historical definition of panic attack?

sudden in onset, peaks within 10 mins, sxs go away <1 hour

how long does agoraphobia last?

>6 months

what is GAD?

excessive anxiety occurring more days than not for >6 months where an individual finds it difficult to control

how is GAD diagnosed?

3 out of 6 of the sxs: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

what is a consideration with anxiety?

get bloodwork to determine associated medical condition4

how is GAD managed?

CBT w/ pharmacotherapy

what is the pharmacotherapy for GAD?

benzos, buspirone, or beta blockers

what do you need to make sure doing with longer-acting benzos?

bridge therapy

what is a great med for GAD w/out depressive features?

buspirone

what other conditions can antidepressants be used for?

GAD, panic disorder, or social anxiety disorder

what is somatic symptom disorder?

excessive thoughts, feelings, or behaviors related to somatic symptoms or associated health concerns

what is illness anxiety disorder?

individuals are seeking care or avoiding it for their preoccupation of having a serious illness

what is an example of functional neurological symptom disorder where there is no evidence of a seizure but the pt thinks it is?

psychogenic nonepileptic seizures

what is treatment for functional neurological symptom disorder?

biofeedback

is symptom production intentional in factitious disorder?

yes

what is munchausen by proxy?

factitious disorder imposed by another

what are underlying motivators a person may have that causes them to behave in certain ways?

gain (primary or secondary)

what is primary gain vs secondary gain?

internal motivators (feeling unwanted); external motivators (serving a useful purpose)

what is indicated for patients identified as having a factitious disorder?

early psychiatric consultation

how is factitious disorder treated?

building a therapeutic clinician-pt relationship (empathetic, realistic, optimistic)