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60 Cards in this Set
- Front
- Back
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Which of the following is most common?
- social anxiety disorder - panic disorder - major depression - alcohol dependence - GAD - OCD |
Major depressive disorder
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How to distinguish normal anxiety from pathological anxiety?
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Pathological anxieties interferes with social and occupational functioning.
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How to differentiate fear and anxiety?
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Fear: response to known, external definite threat.
Anxiety: response to unknown threat or internal, vague or conflictual threat. |
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What kind of symptoms often accompany anxiety?
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autonomic symptoms:
- headaches - perspiration - palpitations - tightness in the chest - mild stomach discomfort - restlessness |
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What is this?
- discrete periods of discomfort/fear ( palpitations, hot flashes, chest pain, nausea, dizziness, fear of dying) - last 20 min - 8 hrs - unexpected - at least 1 month of worrying of another episode |
Panic disorder
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A 24 year old woman complains about episodes of palpitations, sweatiness, dizziness, nausea, that last about 30 minutes each time. She's been worried about these episodes occurring for couple months and got to a point where she has been avoiding going to public places such as restaurants and movie theaters due to possible embarrassment.
What's her diagnosis? What is a good short term treatment for it? What is a good long term treatment for it? Is there a good psychotherapy for it? |
- She has panic disorder.
- Short term treatment: Benzodiazepine. - Long term treatment: SSRIs - CBT |
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What medications may precipitate panic attacks?
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- caffeine
- aminophylline (bronchodilator - sympathetomimetics - monosodium glutamate - alcohol, benzodiazepine, other sedative/hypnotics withdrawal - antipsychotics - oral contraceptives - thyroid hormone |
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What substances induce panic?
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- beta agonist: isoproterenol
- alpha2 blocker: yohimbine - CO2 - sodium lactate |
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What are some possible theories of causes of panic disorders?
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- increased catecholamine levels in the CNS
- abnormal locus ceruleus - CO2 hypersensitivity - problems in lactate metabolism - GABA neurotransmitter problem |
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Which defense mechanism may explain panic attacks?
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repression: when thoughts can no longer be repressed, they breaks into conscious in a distorted way causing anxiety and panic.
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How does CBT help people with panic disorders?
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cognitive part: identify incorrect thoughts that cause increases in anxiety and replace those with correct thoughts.
behavior part: learn relaxation technique, breathing exercises. |
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What is this?
restlessness persistent anxiety >6 months difficulty concentrating sleep disturbance easily fatigued irritable |
GAD
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GAD in more common in ___ (male/female), and ____ (age).
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more prevalent in female
in 20s |
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T/F: GAD often accompanied by depression and substance abuse.
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T.
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What are some possible cause of GAD?
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neurotransmitter problems:
- NE - serotonine in frontal lobe - GABA Limic system |
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Busipirone is specific for ___.
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GAD
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What are some psychotherapeutic options for people with GAD?
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- education about the disease
- psychodynamic to increase anxiety tolerance - behavior therapy: relaxation, re-breathing exercises. |
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What groups of people are more likely to have GAD?
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- women
- African Americans - younger than 30s |
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What is this?
excessive avoidance of social performance for >6 month recognizes the excessive fear being unreasonable |
social phobia
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Female or male?
More likely to have social phobia. |
female = male (trick question!)
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What is the age onset of social phobia?
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usually in the teens
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Describe the clinical course of social phobia.
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slow and chronic
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Does social phobia run in families?
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Yes!
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What is the underlying cause of social phobia?
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low dopamine level
low D2 receptor level/ DA transmitter |
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People with social phobia are more responsive to which class of drugs? less responsive to which class of drugs?
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- MAOI: have DA activity
- TCA: little DA activity |
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How to differentiate social phobia from avoidant and schizoid personality?
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avoidant personality: fear social relationship more than social situations.
schizoid personality: does not seek social situations as sees no reasons to do so. |
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What are some psychotherapies that apply to people with social phobia?
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CBT
- social skills - systematic desensitization - flooding |
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Name some types of specific phobias.
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- animals
- natural environment: height, storm, water - blood, injection - situational |
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What is this?
excessive fear of height cause marked distress, intense anxiety interferes with normal living person realizes the fear being excessive and unreasonable |
specific phobia
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Female or male?
More likely to have specific phobia. |
Female
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What is the usual age of onset for specific phobia?
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childhood, before age 12
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Does specific phobia run in families?
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Yes.
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T/F: People usually outgrow specific phobia.
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True.
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What is the mainstay treatment for specific phobia?
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- behavioral therapy/ exposure therapy: flooding, systemic desensitization.
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When can you use benzodiazepine to treat people with specific phobia?
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when exposure to stimulus is infrequent yet predictable, and causes significant stress if not treated.
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What is this?
excessive repetitive behavior marked stress >1 hour per day significantly interferes with normal routine person realizes the excessiveness and unrealistic |
OCD
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What are some examples of obsessions in OCD?
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- aggression: physical, verbal
- contamination-excretions - symmetry-orderliness - sexual, impulses - hoarding-collecting items - somatic preoccupation with body parts - religious exercises |
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Female or male?
More prevalence of OCD. |
equal
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What is the usually age onset of OCD?
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late teens, early 20s.
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Recently, researchers found out that beta streptococcal infection may cause this anxiety disorder.
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OCD
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Tourette's is often associated with ____.
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OCD
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What is the underlying cause of OCD?
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serotonin system
cingulate sytem more often in people with various neurological diseases: - head trauma - birth injury - epilepsy - chorea |
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Which 2 systems are problematic in people with OCD?
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serotonin
cingulate |
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How to treat OCD?
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- behavioral therapy
- SSRIs: clomipramine - cingulotomy |
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How to differentiate OCD from schizophrenia since obsession frequently resembles delusions?
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OCD: obsession is often resisted an recognized by patient as being internal.
Schizophrenia: delusions are not resisted and are of external origin. |
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How differentiate OCD from obsessive-compulsive personality disorder?
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OCD: obsession-compulsion > 1hour
OCPD: obsession-compulsions seen as helpful. |
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What are the three elements of PTSD?
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- re-experiencing
- avoidance - increased arousal |
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Recollections of traumatic events, distressing dreams about the event, feeling that event is recurring are called ____ symptoms of PTSD.
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re-experiencing
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In patients with PTSD, what type of symptom are the following?
- persistent avoidance of stimuli associated with the trauma - diminished interest in activities - feeling detached from others - sense of foreshortened future |
avoidance symtoms
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In patients with PTSD, what type of symptom are the following?
- difficulty falling asleep - irritability - difficult concentrating - hyper-vigilance - exaggerated startle response |
arousal symptoms
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What is the length criteria for PTSD?
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>1month
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How to classify acute, chronic, and delayed type PTSD?
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acute: <3 months
chronic: >3 months delayed: at least 6 months after the stressor |
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What are some good prognostic signs for PTSD?
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- rapid onset
- good premorbid function - absence of comorbidity - strong social support |
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T/F: Children are more likely to develop PTSD than adults.
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T.
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Biological abnormalities in PTSD:
- sleep - brain strucure - NT system - endocrine |
- sleep: decreased REM latency
- brain: decreased hippocampal volume, increased activity in amygdala(limbic) - NT: NE and serotonin - endocrine: dysregulation of HPA axis |
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What is the best medication treatment for PTSD?
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SSRI
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What are some psychotherapy applicable for PTSD?
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- individual and group therapy
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What is the precursor disease of PTSD?
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acute distress syndrome
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What is the length criteria for acute distress syndrome?
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2-4wks
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What kind of medication can be used for acute distress syndrome?
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- brief course of benzodiazepine
- beta blocker within 4 hrs: EPI increases laying down of memory. |
