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31 Cards in this Set
- Front
- Back
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NTs in anxiety
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increased NE
decreased GABA |
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NTs in depression
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decreased serotonin and 5-H1AA
abnormal regulation of beta adrenergic receptors NE and dopamine probably involved high cortiso; low TSH release by trh GABA and endogenous opiates? |
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Panic Attach criteria
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discrete period of intense fear and discomfort
at least four of PANNICCCSSS |
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Panic symptoms
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PANNICCCSSS
Palpitations Abdominal distress Numbness, nausea Intense fear of death Choking, chills, CP Sweat, shaking, SOB |
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Panic disorder criteria
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recurrent panic attacks
no obvious precipitant at least 1 attack followed by 1 month of: - persistent worry of additionals - worry about implications of attack - change in behavior |
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specifiers of Panic disorder
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with or without agoraphobia!!!!
don't forget to include this |
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tx for panic disorder
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initially with benzos but get off quickly
SSRIs (esp paroxetine and sertraline), start at low dose and go up slowly to avoid activation and anxiety can use clomipramine and imipramine |
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ssri's for panic disorder
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paroxetine and sertraline
Panic Solvers |
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do beta blockers work in panic disorder?
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not as well as benzos
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Criteria for agoraphobia
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anxiety about places without escape/help in event of panic attack
avoided, distressfully endured, or faced only with companion not better explained by another mental disorder |
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specific phobia criteria
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persistent, excessive by specific situation/object
exposure brings immediate response fear recognized as excessive avoidance when possible if under 18, duration is at least 6 months |
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NTs in phobias
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adrenergics
thus beta blockers work!!! |
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tx for specific phobia
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rx does not work
desensitization (which can include benzos/beta blockers) |
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tx for social phobia
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paroxetine
beta blockers for performance anxiety |
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OCD criteria
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Obsessions or compulsions
Aware that unreasonable and excessive Cause marked distress, time consume, interfere |
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rate of OCD higher in patients with 1st degree relatives having
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tourettes
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OCD symptoms with lack of insight
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NOT OCD.. Think OCPD
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NT in OCD
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serotonin
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mos common cause
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stressful life event in 60% of cases
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OCD tx
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both rx and therapy
SSRIs (at high doses) TCAs (clomipramine) ERP exposure and response prevention ECT or cingulotomy as last resort |
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PTSD criteria
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event witnessed
persistent reexperiencing avoiding stimuli numbing of response increased arousal symptoms for 1 month |
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comorbidities with PTSD
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substance abuse
depression |
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pharm tx for PTSD
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TCAs
SSRIs, MAOIs anticonfulsants psychotherapy relaxation support groups, family therapy |
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difference between PTSD and Acute Stress disorder
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PTSD: any time in past, symptoms >1 month
Acute: event < 1month ago, symptoms last <1 month |
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GAD criteria
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persistent, excessive anxiety/hyperarousal
about daily events at least 6 months associated with 3 of: restlessness, fatigue, diff concentration, irritability, muscle tension sleep disturbance |
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GAD symptoms
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3 of:
Real Fears Don't Irritate My Sleep Restlessness Fatigue Difficulty concentrating Irritability Muscle tension Sleep disturbance |
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lifetime prevalence of GAD
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45%
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tx for GAD
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therapy plus meds
- buspirone, benzos, SSRIs SNRIs - Behavioral, Psychotherapy |
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criteria for adj disorder
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symptoms within 3 months
end within 6 months excessive distress cause significant impairment not bereavement |
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subtypes of adj disorde
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predominance of:
- depressed mood, - anxiety, - conduct disturbance or - combinations of the above |
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tx for adj disorder
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supportive psychotherapy
group therapy pharm for associated symptoms |
