T3 L3: Anxiety Disorders: Clinical Picture (SBa)
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Questions and Answers

According to the lecture, what percentage of individuals may meet the criteria for an anxiety disorder during the course of their lives?

  • 1%
  • 20%
  • 60%
  • 40% (correct)

    • What is the incidence of the most severe mental disorders, such as bipolar disorders and schizophrenia?

  • 20%
  • 1% (correct)
  • 60%
  • 40%

    • How does the lecture describe the disability caused by anxiety disorders compared to severe mental illness?

  • Anxiety disorders have no impact on disability.
  • Anxiety disorders are less disabling than severe mental illness.
  • Anxiety disorders are equally disabling as severe mental illness.
  • Anxiety disorders are more disabling than severe mental illness. (correct)

    • What physiological responses occur during the normal stress response described in the lecture?

    <p>Increased heart rate and secretion of adrenaline and cortisol.</p> Signup and view all the answers

    Which of the following is a key feature of an acute stress reaction?

    <p>The time course is limited to three days</p> Signup and view all the answers

    What is the main difference between anxiety and fear?

    <p>Anxiety is an anticipated threat, while fear is an imminent threat</p> Signup and view all the answers

    Which of the following is a common symptom of adjustment disorder?

    <p>Depression</p> Signup and view all the answers

    What is the nature of the trigger that leads to a diagnosis of PTSD?

    <p>An exceptionally threatening or catastrophic event</p> Signup and view all the answers

    Which of the following is a key symptom of post-traumatic stress disorder (PTSD)?

    <p>Flashback memories or nightmares</p> Signup and view all the answers

    Which of the following is a key feature of generalized anxiety disorder?

    <p>Fearful anticipation of something bad happening</p> Signup and view all the answers

    Which of the following is a symptom of depersonalization/derealization disorder?

    <p>Feeling sad and depersonalized</p> Signup and view all the answers

    Which of the following is a risk factor for developing an anxiety disorder?

    <p>Experiencing a negative event in the previous year</p> Signup and view all the answers

    Which of the following is a common symptom of panic attacks?

    <p>Palpitations</p> Signup and view all the answers

    What is the main difference between panic attacks and asthma attacks?

    <p>Panic attacks cause difficulty in filling the lungs with air</p> Signup and view all the answers

    What can be a potential differential diagnosis for patients presenting with symptoms of panic?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is required for a diagnosis of panic disorder?

    <p>Repeated episodes of panic attacks over a period of time</p> Signup and view all the answers

    Which of the following is a common precipitant for panic attacks?

    <p>Early childhood trauma</p> Signup and view all the answers

    What is the mainstay of treatment for panic attacks?

    <p>SSRI</p> Signup and view all the answers

    Which neurotransmitter system is implicated in the treatment of anxiety with benzodiazepines?

    <p>GABA transmission</p> Signup and view all the answers

    What is the reason behind the fear of heights in indigenous people who built New York skyscrapers?

    <p>Genetic predisposition</p> Signup and view all the answers

    Which treatment had the patient not received?

    <p>Oxidase inhibitor</p> Signup and view all the answers

    What drug did the doctor start the patient on?

    <p>Phenelzine</p> Signup and view all the answers

    What was the patient's response after taking Phenelzine?

    <p>He experienced a miracle</p> Signup and view all the answers

    What did the day hospital staff say to the doctor?

    <p>They don't do hugs</p> Signup and view all the answers

    What was the hallmark of the super responders?

    <p>Mild mania</p> Signup and view all the answers

    What did the patient want from the NHS?

    <p>A hug and someone to talk to</p> Signup and view all the answers

    Which of the following is NOT a common phobic response?

    <p>Tachycardia</p> Signup and view all the answers

    What is the usual response to a phobic stimulus like a snake?

    <p>Sympathetic activation</p> Signup and view all the answers

    What is the treatment for fear of flying?

    <p>Exposure therapy</p> Signup and view all the answers

    What did the studies by American psychologist Monica show about fear in chimpanzees?

    <p>Wild born chimpanzees show a panic response to a snake, while laboratory bred animals don't</p> Signup and view all the answers

    Which of the following is a key symptom of post-traumatic stress disorder (PTSD)?

    <p>Flashbacks and nightmares</p> Signup and view all the answers

    What is the lifetime prevalence of generalized anxiety disorder (GAD) according to ICD-10 criteria?

    <p>8.9%</p> Signup and view all the answers

    Which of the following is a risk factor for developing an anxiety disorder?

    <p>Genetic predisposition</p> Signup and view all the answers

    What is the main difference between panic attacks and asthma attacks?

    <p>Psychic symptoms</p> Signup and view all the answers

    What is the clinical picture of panic disorder?

    <p>Fear of losing control</p> Signup and view all the answers

    What is the estimated recovery rate for individuals with PTSD within 1 year?

    <p>Most recover within 1 year</p> Signup and view all the answers

    What is the mainstay of treatment for panic attacks?

    <p>Cognitive-behavioral therapy</p> Signup and view all the answers

    What is the association between stressful life events and generalized anxiety disorder (GAD)?

    <p>Association found</p> Signup and view all the answers

    What is the role of early parenting experiences in the development of anxiety and depression?

    <p>Mediated by cognitive vulnerability</p> Signup and view all the answers

    What is the prevalence of GAD estimated to be in patients in primary care clinics?

    <p>3x higher</p> Signup and view all the answers

    Which of the following is a common symptom of panic attacks?

    <p>Tachycardia</p> Signup and view all the answers

    What is the lifetime prevalence of panic disorder?

    <p>1.5-2.5%</p> Signup and view all the answers

    What is the suggested genetic predisposition for panic disorder?

    <p>7-fold increased risk in first-degree relatives</p> Signup and view all the answers

    What is a common precipitating event for panic attacks?

    <p>Relationship difficulties</p> Signup and view all the answers

    What is the mean age of onset for obsessive-compulsive disorder (OCD)?

    <p>20 years</p> Signup and view all the answers

    What is the prevalence of OCD in the population?

    Signup and view all the answers

    What is a common comorbidity with OCD?

    <p>Major depressive episode</p> Signup and view all the answers

    What is the suggested genetic influence on OCD?

    <p>Higher incidence in monozygotic twins</p> Signup and view all the answers

    What is the main difference between anxiety and fear?

    <p>Anxiety is a biological failure, fear is a psychological weakness</p> Signup and view all the answers

    What is the mainstay of treatment for panic attacks?

    <p>Antidepressants</p> Signup and view all the answers

    Which of the following is a key symptom of generalized anxiety disorder (GAD)?

    <p>Poor concentration</p> Signup and view all the answers

    What is the estimated lifetime prevalence of schizophrenia?

    <p>1%</p> Signup and view all the answers

    What is the main difference between panic attacks and asthma attacks?

    <p>Panic attacks are characterized by sudden feelings of intense fear and terror, while asthma attacks are characterized by difficulty breathing and wheezing</p> Signup and view all the answers

    What is the main difference between anxiety and fear?

    <p>Anxiety is a normal response to a perceived threat, while fear is an excessive and irrational response</p> Signup and view all the answers

    What is the main difference between panic disorder and agoraphobia?

    <p>Panic disorder is characterized by sudden and recurrent panic attacks, while agoraphobia is a fear of being in situations where escape may be difficult or embarrassing</p> Signup and view all the answers

    What is the estimated lifetime prevalence of bipolar affective disorder (Bipolar A.D.)?

    <p>0.8%</p> Signup and view all the answers

    What is the main difference between obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD)?

    <p>OCD is characterized by recurrent and intrusive thoughts, while GAD is characterized by excessive worry and anxiety</p> Signup and view all the answers

    What is the main difference between acute stress reaction and adjustment disorder?

    <p>Acute stress reaction is a normal response to a stressful event, while adjustment disorder is an abnormal response that is out of proportion to the stressor</p> Signup and view all the answers

    What is the main difference between specific phobias and social anxiety disorder?

    <p>Specific phobias are characterized by fear of specific objects or situations, while social anxiety disorder is characterized by fear of social situations</p> Signup and view all the answers

    What is the main difference between post-traumatic stress disorder (PTSD) and acute stress reaction?

    <p>PTSD is a chronic condition that lasts longer than 6 months, while acute stress reaction lasts hours to 3 days</p> Signup and view all the answers

    Which of the following is a symptom of acute stress reaction?

    <p>Feelings of being numb or dazed</p> Signup and view all the answers

    What is the duration of an adjustment disorder?

    <p>Up to 6 months</p> Signup and view all the answers

    What is required for a diagnosis of post-traumatic stress disorder (PTSD)?

    <p>Actual or threatened death or serious injury</p> Signup and view all the answers

    What is the estimated recovery rate for individuals with PTSD within 1 year?

    <p>20%</p> Signup and view all the answers

    Which neurotransmitter system is implicated in the treatment of anxiety with benzodiazepines?

    <p>GABA</p> Signup and view all the answers

    What is the lifetime prevalence of panic disorder?

    <p>19%</p> Signup and view all the answers

    What is the estimated prevalence of generalized anxiety disorder (GAD) in males?

    <p>7%</p> Signup and view all the answers

    What is the estimated prevalence of bipolar affective disorder (A.D.) in females?

    <p>7%</p> Signup and view all the answers

    What is the estimated prevalence of schizophrenia?

    <p>0.8%</p> Signup and view all the answers

    What is the age of onset for schizophrenia?

    <p>39 years</p> Signup and view all the answers

    Study Notes

    Anxiety Disorders

    • Approximately 30% of individuals may meet the criteria for an anxiety disorder during their lives.
    • Generalized anxiety disorder (GAD) has a lifetime prevalence of 4% to 6% according to ICD-10.
    • A common symptom of adjustment disorder includes emotional or behavioral symptoms in response to a stressor.

    Severe Mental Disorders

    • Incidence of severe mental disorders like bipolar disorder is around 1-2%.
    • Schizophrenia prevalence is estimated between 0.3% to 0.7% of the population, with a lifetime prevalence of approximately 1%.

    Disability Comparisons

    • Anxiety disorders can lead to significant disability, often comparable to severe mental illnesses such as bipolar disorder and schizophrenia.

    Stress Response

    • The normal stress response includes physiological reactions such as increased heart rate, muscle tension, and heightened alertness.

    Key Features of Stress Reactions

    • An acute stress reaction features persistent hyperarousal and anxiety following exposure to a traumatic event.

    Differences Between Anxiety and Fear

    • Anxiety is an anticipatory response to a future threat, while fear is a reaction to an immediate threat.

    Post-Traumatic Stress Disorder (PTSD)

    • PTSD is triggered by experiencing or witnessing a traumatic event.
    • Key symptoms include intrusive memories, avoidance of reminders, and negative changes in mood.

    Generalized Anxiety Disorder (GAD)

    • A key feature of GAD is excessive worry about different aspects of life.
    • A risk factor for developing GAD is a history of stressful life events, especially early childhood experiences.

    Panic Attacks

    • Common symptoms include palpitations, shortness of breath, and feelings of impending doom.
    • Panic attacks are distinct from asthma attacks as they do not have a physiological basis of bronchoconstriction.
    • A potential differential diagnosis for panic symptoms could include hyperthyroidism or cardiovascular conditions.
    • Diagnosis of panic disorder requires recurrent, unexpected panic attacks followed by worry about future attacks.

    Treatment Approaches

    • The mainstay treatment for panic attacks includes cognitive-behavioral therapy (CBT) and pharmacotherapy, often benzodiazepines.
    • Benzodiazepines act on the gamma-aminobutyric acid (GABA) neurotransmitter system.

    Phobias and Fear Responses

    • Typical phobic responses include avoidance behaviors which can escalate into anxiety attacks.
    • Fear of flying can be treated with exposure therapy and CBT techniques.
    • Research by psychologist Monica noted that even chimpanzees exhibit fear responses, indicating an inherent fear of threats.

    Comorbidities and Genetic Influences

    • Common comorbidities with obsessive-compulsive disorder (OCD) include anxiety disorders and depression.
    • There is a suggested genetic predisposition for both panic disorder and OCD, with assessments showing family links.

    Recovery Rates and Duration of Disorders

    • Estimated recovery rate for individuals with PTSD within 1 year is around 50%.
    • Adjustment disorder symptoms typically last for less than 6 months following the stressor.

    Prevalence Estimates

    • GAD is estimated to occur in 5-10% of the general population and is higher in primary care settings.
    • The prevalence of panic disorder is approximately 2-3%, with a lifetime prevalence of about 4-5%.
    • The prevalence of bipolar affective disorder is about 1% in the general population, with higher rates in females.

    Onset Ages

    • Mean age of onset for OCD is typically in late adolescence to early adulthood.
    • Schizophrenia onset usually occurs in late adolescence to early adulthood, generally around ages 18-24.

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