Podcast
Questions and Answers
What is a necessary duration for excessive anxiety and worry to be classified as Generalized Anxiety Disorder (GAD)?
What is a necessary duration for excessive anxiety and worry to be classified as Generalized Anxiety Disorder (GAD)?
Which of the following is NOT considered a hallmark symptom of Generalized Anxiety Disorder (GAD)?
Which of the following is NOT considered a hallmark symptom of Generalized Anxiety Disorder (GAD)?
Which group has a higher prevalence of Generalized Anxiety Disorder (GAD)?
Which group has a higher prevalence of Generalized Anxiety Disorder (GAD)?
What is a common physical symptom associated with Generalized Anxiety Disorder (GAD)?
What is a common physical symptom associated with Generalized Anxiety Disorder (GAD)?
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Which factor is NOT a recognized risk factor for developing Generalized Anxiety Disorder (GAD)?
Which factor is NOT a recognized risk factor for developing Generalized Anxiety Disorder (GAD)?
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What is the recommended first-line medication for treating Generalized Anxiety Disorder (GAD)?
What is the recommended first-line medication for treating Generalized Anxiety Disorder (GAD)?
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Which symptom is NOT commonly reported during a panic attack?
Which symptom is NOT commonly reported during a panic attack?
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Which of the following is a significant risk factor associated with Social Anxiety Disorder?
Which of the following is a significant risk factor associated with Social Anxiety Disorder?
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What is the hallmark characteristic of panic disorder?
What is the hallmark characteristic of panic disorder?
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What psychological approach has shown the best evidence for treating Generalized Anxiety Disorder?
What psychological approach has shown the best evidence for treating Generalized Anxiety Disorder?
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In which situation is a person diagnosed with Agoraphobia most likely to experience anxiety according to the DSM-5 criteria?
In which situation is a person diagnosed with Agoraphobia most likely to experience anxiety according to the DSM-5 criteria?
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What is a common misperception about the duration of panic attacks?
What is a common misperception about the duration of panic attacks?
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Which of the following treatments is NOT typically indicated for panic disorder?
Which of the following treatments is NOT typically indicated for panic disorder?
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What is a common emotional response during a panic attack?
What is a common emotional response during a panic attack?
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What is the primary method through which specific phobias are treated?
What is the primary method through which specific phobias are treated?
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Which medication class is typically the first-line treatment for Social Anxiety Disorder?
Which medication class is typically the first-line treatment for Social Anxiety Disorder?
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Which cognitive intervention is primarily used in CBT for treating phobias?
Which cognitive intervention is primarily used in CBT for treating phobias?
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What physiological response is activated during a panic attack?
What physiological response is activated during a panic attack?
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What behavior do individuals with panic disorder often engage in to avoid attacks?
What behavior do individuals with panic disorder often engage in to avoid attacks?
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What is a necessary component for diagnosing Premenstrual Dysphoric Disorder (PMDD)?
What is a necessary component for diagnosing Premenstrual Dysphoric Disorder (PMDD)?
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Which symptom is NOT a criterion for Premenstrual Dysphoric Disorder?
Which symptom is NOT a criterion for Premenstrual Dysphoric Disorder?
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What distinguishes Premenstrual Dysphoric Disorder from Premenstrual Syndrome?
What distinguishes Premenstrual Dysphoric Disorder from Premenstrual Syndrome?
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What is the typical response of Premenstrual Dysphoric Disorder symptoms after the onset of menses?
What is the typical response of Premenstrual Dysphoric Disorder symptoms after the onset of menses?
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Which treatment is recognized as effective for Premenstrual Dysphoric Disorder?
Which treatment is recognized as effective for Premenstrual Dysphoric Disorder?
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Which of the following presentations is characteristic of specific phobias?
Which of the following presentations is characteristic of specific phobias?
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What is NOT considered a risk factor for developing specific phobias?
What is NOT considered a risk factor for developing specific phobias?
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Which treatment is commonly used for managing specific phobias?
Which treatment is commonly used for managing specific phobias?
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What criterion is essential for diagnosing Major Depressive Disorder (MDD)?
What criterion is essential for diagnosing Major Depressive Disorder (MDD)?
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Which of the following symptoms is NOT one of the cardinal symptoms of MDD?
Which of the following symptoms is NOT one of the cardinal symptoms of MDD?
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For which group has research indicated a significantly higher rate of depression?
For which group has research indicated a significantly higher rate of depression?
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Which medication class is considered a first-line treatment for Major Depressive Disorder?
Which medication class is considered a first-line treatment for Major Depressive Disorder?
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What is a hallmark characteristic of Persistent Depressive Disorder?
What is a hallmark characteristic of Persistent Depressive Disorder?
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What is a significant implication of untreated Major Depressive Disorder?
What is a significant implication of untreated Major Depressive Disorder?
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Which type of therapy is generally encouraged for patients with moderate to severe Major Depressive Disorder?
Which type of therapy is generally encouraged for patients with moderate to severe Major Depressive Disorder?
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Which symptom is a requirement for diagnosing Major Depressive Disorder?
Which symptom is a requirement for diagnosing Major Depressive Disorder?
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What would be considered a differential diagnosis when evaluating depression symptoms?
What would be considered a differential diagnosis when evaluating depression symptoms?
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What is an essential follow-up step after initiating treatment for Major Depressive Disorder?
What is an essential follow-up step after initiating treatment for Major Depressive Disorder?
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Which medication's warning cautions against use in individuals up to 24 years of age due to increased risk of suicidal ideations?
Which medication's warning cautions against use in individuals up to 24 years of age due to increased risk of suicidal ideations?
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Study Notes
Generalized Anxiety Disorder (GAD)
- GAD and Panic Disorder are prevalent mental disorders in the U.S., especially among individuals aged 18-64.
- Characteristic symptoms include excessive, uncontrolled worry impacting daily life.
- More common in women than men.
- GAD often presents through excessive anxiety about daily situations, leading to functional impairment and distress.
- Associated physical symptoms include sleep disturbances, restlessness, gastrointestinal issues, and chronic headaches.
Risk Factors and Associations
- Increased likelihood of GAD in females, unmarried individuals, those with low education, and poor health.
- Median onset age is around 30 years.
Diagnostic Criteria
- Symptoms must occur more days than not for at least 6 months with difficulty controlling the worry.
- Requires at least 3 of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbances.
- Symptoms must cause clinically significant distress or impairment.
- Disturbance must not be attributable to substances or other medical conditions.
Treatment and Management
- First-line medications include SSRIs and SNRIs such as Duloxetine and Escitalopram.
- Buspirone is particularly effective for GAD and should be continued for 12 months post-symptom improvement to prevent relapse.
- Benzodiazepines can aid in short-term recovery when used with SSRIs.
- Psychotherapy, notably Cognitive Behavioral Therapy (CBT), has strong evidence for effectiveness.
- Incorporating physical activity is recommended.
Panic Disorder
- Characterized by recurrent and unexpected panic attacks, impacting daily life and overall well-being.
- Commonly occurs in individuals aged 18-64, with a higher prevalence in women.
- Panic attacks have an abrupt onset, peak within 10-15 minutes, and rarely last longer than 30 minutes.
- Typical symptoms include intense fear, palpitations, sweating, chest pain, and shortness of breath.
Treatment and Management
- SSRIs such as Prozac and Lexapro are first-line treatments.
- TCAs are more beneficial for panic disorder than GAD.
- Similar to GAD, treatment extension for 12 months post-symptom relief is advised.
- Physical activity is beneficial.
Phobias
- Phobias are one of the most common mental disorders in the U.S., with a higher prevalence in women.
- Types of phobias include Social Phobia, Agoraphobia, and Specific Phobias (e.g., fear of snakes).
Social Phobia
- Identical to Social Anxiety Disorder, marked by fear of being judged in social situations.
- Can significantly impair daily activities and relationships, with 80% developing symptoms before the age of 20.
- Risk factors include genetic predisposition, past negative experiences, and psychological factors.
DSM-5 Criteria for Social Anxiety Disorder
- Persistent fear of social situations where one may be judged or humiliated.
- Avoidance of such situations leads to significant distress and must not be explained by other conditions.
Treatment and Management for Social Phobia
- First-line treatment is psychotherapy, particularly CBT, which offers long-term benefits.
- SSRIs may be prescribed if therapy is not pursued.
Agoraphobia
- More common in women, usually begins in early adulthood and is rare in children.
- Fear is associated with leaving home or being in situations difficult to escape from.
DSM-5 Criteria for Agoraphobia
- Marked fear or anxiety about at least two specific situations (e.g., public transportation, open spaces).
- Symptoms must lead to avoidance behavior and cause significant distress or impairment.
Risk Factors for Agoraphobia
- Thought to result from genetic and environmental factors, including substance-induced conditions.
Treatment and Management of Agoraphobia
- First-line treatments include CBT and Systematic Desensitization (Exposure Therapy).
- Exposure therapy involves gradual exposure to feared situations paired with relaxation techniques for fear reduction.
- Without treatment, recovery is uncommon.
Cognitive Behavioral Therapy (CBT)
- Focuses on identifying and altering negative automatic thoughts linked to phobic reactions.
- Emphasizes the interplay between thoughts, feelings, and behaviors, demonstrating their impact on each other.
Specific Phobia
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Five types of specific phobias exist:
- Natural/Environmental: Includes fears of nature-related events, e.g., thunder (Astraphobia), water (Aquaphobia).
- Injury: Fear of physical harm, such as dental procedures (Dentophobia) or injections (Trypanophobia).
- Animal: Involves fears related to animals or insects, e.g., dogs (Cynophobia), snakes (Ophidiophobia), and insects (Entomophobia).
- Situational: Triggered by specific situations like washing (Ablutophobia) and enclosed spaces (Claustrophobia).
- Other: Encompasses fears that do not fit the above categories, e.g., fear of dolls or loud noises.
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Presentations typically include unreasonable and excessive fear, immediate anxiety response, avoidance behaviors, and significant life limitations. Symptoms last at least 6 months and are not attributed to other disorders.
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Risk factors include temperament (behavioral inhibition), genetic predisposition if a family member suffers from anxiety disorders, and stressful or traumatic experiences. There is an elevated risk of suicide associated with the disorder.
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Treatment primarily involves Cognitive Behavioral Therapy (CBT) and systematic desensitization, often combined with SSRIs. Benzodiazepines and Propranolol are also used as needed for anxiety attacks, although medications are not typically used alone.
Depressive Disorders
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Over 300 million people worldwide are affected by depression, often under-recognized in general healthcare settings. Approximately 75% receive treatment in primary care rather than mental health facilities.
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Stigma and psychosocial barriers hinder individuals from seeking help. Patients with chronic medical conditions are nearly three times more likely to experience depression compared to healthy individuals.
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Major Depressive Disorder (MDD) has significantly higher depression and suicide rates in transgender populations (~50%), with the highest rates seen among adults of two or more races.
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MDD etiology includes genetic predisposition, physiological and immunological factors, and social/psychological influences such as life stress and lack of social support.
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MDD diagnosis requires at least five of nine cardinal symptoms to be present for two weeks, including one symptom of depressed mood or anhedonia. Important to note that depressed mood is distinct from mere sadness.
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Nine cardinal symptoms include changes in mood and interest, weight fluctuations, sleep issues, fatigue, feelings of worthlessness or guilt, decreased concentration, and thoughts of death.
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Physical exams rule out underlying medical conditions but no specific diagnostic tests exist for MDD. Differential diagnoses include bipolar disorder, anxiety disorders, substance use disorders, and other psychiatric or medical conditions.
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PHQ-9 is a tool used to assess diagnosis and severity; follow-up is crucial for medication efficacy, with SSRIs being a common first-line treatment. Patients should remain in treatment for 6-12 months post-remission and receive routine evaluations.
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Refractory cases may require additional interventions, including Electroconvulsive Therapy (ECT) or Transcranial Magnetic Stimulation (TMS), with ketamine emerging as a treatment for resistant depression.
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SSRIs and SNRIs (e.g., Prozac, Zoloft) are the most prescribed antidepressants, with a black box warning for individuals under 24 regarding increased suicidal ideations.
Persistent Depressive Disorder (Dysthymia)
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Persistent Depressive Disorder is a chronic form of depressive illness, combining features of chronic MDD and dysthymia, leading to long-lasting disability.
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A diagnosis is made when depressed mood and at least two other symptoms persist more than half the days over the last two years (one year for children/adolescents).
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Responds well to antidepressant medications; if MDD criteria are met during the illness, the patient should be diagnosed with MDD.
Premenstrual Dysphoric Disorder
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Diagnosed when five or more symptoms of emotional, behavioral, or physical dysregulation appear in the week before menses for most menstrual cycles. Symptoms improve shortly after the onset of menses.
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Key symptoms include mood swings, irritability, depression, and anxiety that cause significant distress or impairment in daily functioning.
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Treatment primarily involves SSRIs or contraception for ovulation suppression.
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Description
This quiz covers the characteristics and prevalence of Generalized Anxiety Disorder (GAD) as one of the most common mental disorders in the U.S. It explores symptoms, age demographics, and the distinction between GAD and Panic Disorder. Understanding GAD is critical for recognition and treatment.
