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44 Cards in this Set
- Front
- Back
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What is the difference between fear and anxiety?
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Fear is the emotional and physiological response to a recognized external threat.
Anxiety is an unpleasant emotional state. |
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How long should the symptoms of a panic attack last?
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Usually should go away within 10 minutes.
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Substances that can precipitate panic attaks:
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Caffeine, alcohol, marijuana, thyroid supplements, sympathomimetics, stimulants, yohimbine.
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Which cardiac abnormality is often seen in pts with panic attack?
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Mitral valve prolapse in 50% of pts with panic disorder.
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DDx of panic attack:
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AMI
Arrhythmia CHF Angina PE Asthma IBS |
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Common drugs used to treat panic attacks:
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SSRIs
Tricyclics MAOIs Benzos Also propanolol |
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What comorbid conditions are associated with social phobias:
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Depression, EtOH, avoidant personality disorder
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DDX for social phobia:
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Schizophrenia
MDE OCD Schizotypal personality disorder Avoidant personality disorder |
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What's the difference between an obsession and compulsion?
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Obsessions are recurrent intrusive thoughts, feelings, or ideas
Compulsions are conscious recurrent behaviors (counting, hand washing, avoiding. |
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What is the main neurotransmitter implicated OCD?
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Serotonin
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What is the main way to distinguish OCD from OCPD?
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People with OCD tend to be distressed by their thoughts, while OCPD don't.
Also OCPD is rigid in their application of everything, while OCD is limited to specific issues. |
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What anatomical and functional abnormalities are often seen in OCD?
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Enlarged ventricles and decreased volumes of caudates.
Defects in caudate nuclei and prefrontal cortex. |
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Treatment of choice in OCD
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Behavior therapy.
If you are going to use medications, go with SSRI |
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When is surgery indicated for OCD?
What is the procedure? |
Sterotaxic limbic leukotomy and anterior capsulotomy.
Only do when patient is severely ill and has failed other treatments. |
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What are the criteria for diagnosing PTSD:
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1. Person experienced or witnessed a traummatic event outside the realm of ordinary
2. Person had an intense response 3. Symptoms have persisted longer than 3 months. |
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What is the term for "PTSD" within the first 3 months of a traummatic event?
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Acute stress disorder
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What are the criteria for acute stress disorder?
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Witnessed or experienced a traumatic event.
Symptoms present at least 2 days following exposure (but less than 3 months) Symptoms cause distress/impairment Evidence of dissociative symptoms during or after the event. |
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What are the 3 core symptoms of PTSD?
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Reexperiencing
Avoidance Incerased arousal |
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Risk factors for developing PTSD:
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Severity, duration, and proximity to the traumatic event.
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Which neurotransmitter is associated with PTSD?
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Catecholamines - NE, Epi, Dopamine
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Treatment of PTSD
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SSRIs, beta blockers, MAOIs, tricyclics
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Prognosis of PTSD:
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30% recover, 10 % remain unchanged, remaining 60% in the middle.
Good factors include rapid onset of symptoms, short duration, good premorbid fx, social support, absence of other psychiatric disorders. |
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What percentage of pts with GAD have other psychiatric illnesses:
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50%
Note that 60% of patients with MDE have anxiety symptoms as well |
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Drugs commonly used to treat GAD:
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Beta blockers
Buspirone TCAs Antihistamines |
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List 3 common long acting benzos:
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Diazepam (Valium)
Chlordiazepoxide (Librium) Flurazepam (Dalmane) |
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List 3 short acting benzos:
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Trazolam (Halcion)
Alprazolam (Xanax) Lorazepam (Ativan) |
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3 advantages to using Buspar?
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No sedation
No interaction with alcohol No dependence |
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How long does it take for Buspar to work?
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3 weeks
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Common uses for benzos:
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GAD
Insomnia Panic disorder Agitation Akathisia EtOH withdrawal |
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Antihistamine that can be used as an anxiolytic:
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Hydroxyzine
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Besides depression, in what conditions could you use MAOIs?
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Social phobias
OCD PTSD |
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Diagnosis of Panic DISORDER
(Not panic attack) in a nutshell |
Spontaneous and recurrent panic attacks
Persistant worry about having additional panic attacks for a minimum of 1 month following an attack. |
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How many physical symptoms must be present to diagnose a panic attack?
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Four
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Neurotransmitters implicated in anxiety:
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NE, GABA
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Average age of onset of panic disorder?
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25
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What specifier MUST be present when diagnosing panic disorder?
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Whether it occurs with or without agoraphobia
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When usign SSRIs to treat panic disorder, how does the dosing compare to using them to treat depression?
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Must use a higher dosage
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How long must a stressor/situation be present in a kid to diagnose him with a specific phobia?
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6 months
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Most common mental disorder in the USA?
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Spcific phobia
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What is the first line treatment for specific phobias?
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Systemic desentization
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PTSD vs Acute Stress Disorder in terms of:
1. How long ago the event occured 2. How long the symptoms have lasted |
1. In acute stress disorder, the symptoms must have occured within the past month, while in PTSD they could have occured anytime in the past
2. In ASD symptoms have lasted 1 month, while in PTSD they've lasted more than a month. |
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Diagnostic criteria for GAD (in a nutshell)
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Sx lasted 6 months, and three of the following [Restlessness, fatigue, concentration difficulties, Irritability, Muscle Tension, Sleep problems]
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Time frame for Adjustment disorder:
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Symptoms began within 3 months of the stressor and ended within 6 months of the stressor.
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Treatement for adjustment disorder:
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1. Supportive psychotherapy (most effective)
2. Group therapy 3. Pharmcotherapy for assoc. symptoms (eg insomnia) |
