What is the dx criteria for Generalized Anxiety Disorder? - anxiety on most days (six or more
months) and w/ three or more somatic sx (restlessness, fatigue, difficulty concentrating, irritability,
muscle tension, dist
...
What is the dx criteria for Generalized Anxiety Disorder? - anxiety on most days (six or more
months) and w/ three or more somatic sx (restlessness, fatigue, difficulty concentrating, irritability,
muscle tension, disturbed sleep)
How is GAD tx? - Lifestyle changes
psychotherapy
medication
- SSRIs
- Venlafaxine
- buspirone
- Benzos for immediate sx relief
How does OCD present? - Obsessions: persistent, unwanted, and intrusive ideas, thoughts, impulses,
or images that lead to marked anxiety or distress and occur despite the patient's attempts to
prevent them
Compulsions: repeated mental acts or behaviors that neutralize anxiety from obsessions (e.g.
handwashing, elaborate rituals for ordinary tasks, counting, excessive checking)
Pts recognize these behaviors as excessive and irrational products of their own minds. Wish to get
rid of the obsessions and/or compulsions
How is OCD tx? - Pharmacotherapy
- SSRIs (first line)
CBT
- exposure and desensitization relaxation techniquesPt education
How do panic attacks present? - Discrete periods of intense fear or discomfort in which at least 4 of
the following sx develop abruptly and peak w/in 10 min:
- tachypnea
- chest pain
- palpitations
- diaphoresis
- nausea
- trembling
- dizziness
- fear of dying or "going crazy"
- depersonalization
- hot flashes
- perioral and/or acral paresthesias-->hyperventilation and low O2 sats
one or more months of concern about having additional attacks or significant behavior change as a
result of the attacks--avoiding situations that may precipitate attacks
What other conditions should be considered when a pt presents w/ panic attack? - Angina
MI
arrhythmias
hyperthyroidism
Vita B12 deficiency
pheochromocytoma
substance-induced anxiety
generalized anxiety disorderPTSD
How are panic disorders treated? - CBT
pharmacotherapy
- SSRIs
- TCAs
Benzos
- for immediate relief, but avoid long-term use
- taper as soon as long term tx is on board
What is the difference between OCD and OCPD? - OCD is ego-dystonic: recognize the
obsessions/compulsions and want to be rid of them
OCPD is ego-syntonic: do not recognize their behavior as problematic
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