Anxiety and Affective Disorders Tutorial PDF

Briefing for Anxiety and Depression tutorial for Students Learning outcome: “To use active learning with other students to reinforce your understanding of anxiety disorders and affective disorders.” Description of learning outcome  Active learning means that the students interact with each other to...

Briefing for Anxiety and Depression tutorial for Students Learning outcome: “To use active learning with other students to reinforce your understanding of anxiety disorders and affective disorders.” Description of learning outcome  Active learning means that the students interact with each other to gain knowledge. This is NOT a tutor-driven review session. The students provide information to each other. The tutor is a resource for information only, and the tutor maintains order in the classroom. Whom you sit next to will make a difference in your experience of this session.  Your understanding of anxiety disorders and affective disorders takes place at many levels. Imagine you had an essay exam where you received the title of the essay in advance, and the title of your essay was, “Describe the relevant medical and scientific issues of anxiety and affective disorders.” You and your classmates should discuss these issues as if you had such an essay exam to prepare for. This session should cover all facets of this information, but at an introductory level. This includes symptoms, differential diagnoses, functional neuroanatomy, epidemiology, molecular mechanisms, pharmacotherapies, and notorious adverse reactions. You do not need to be an expert or at the level of a professional psychiatrist, but you should have broad awareness of the issues. All the information will have been provided by the lectures; no new information is meant to be presented in this tutorial. Method A wide range of questions have been provided to guide your thinking and discussions with your classmates (see next page). Due to time limitations, you will be recommended to pursue a particular set of them; you will be given time (3-5 minutes) in class to break into small groups and informally discuss one particular issue, and then the tutor will reconvene the entire class to discuss the answer. While you are in small groups, you may invite the tutor to join you in order to clarify uncertainties. Also, while you are in small groups, you may ask the tutor other questions not directly related to the question being considered by the class. When reconvened as a class, the tutor will mediate such that different members of the class can speak to the group. If a matter of confusion arises which is outside the remit of the question being discussed, the tutor and class may choose to pursue that topic briefly. Lectures covered by this tutorial (all in theme 3):  Affective disorders: Clinical aspects. (AC)  Affective disorders: Neurobiology and treatment. (AC)  Anxiety disorders: clinical picture. (SBa)  Anxiety disorders: neurobiology, neurochemistry and treatment. (NS) Related but not covered in depth  Psychobiology of emotion. (HC) 1 Selected Questions to consider during the tutorial 1 & 5 / 21 & 26 / 20 & 18 / 15 & 16 / 11 & 12 / 4 & 8 / 24 & 29 / 35 & 36 / 31 & 32 Because each tutorial is uniquely determined by the students participating in them, you may not have time to cover all of the above questions. THE QUESTIONS Symptoms and diagnosis (including Nosology) 1. Name 5 different anxiety disorders. 2. For each of the anxiety disorders, explain how they would be likely to present, and how they would be diagnosed via symptoms and history. 3. Name major differences in symptoms between the different anxiety disorders. 4. Describe the epidemiology of the different anxiety disorders. This should include point prevalence (if you were taught it), lifetime prevalence (if you were taught it), typical age of first presentation, genetic components (if known), and gender differences (if there are any). 5. Name 3 different affective episodes and two affective disorders. 6. Distinguish between mania and hypomania. 7. For Major Depressive episodes and Manic episodes, list how they would be likely to present at the mental state examination. 8. For Major Depressive episodes and Manic episodes, mention the main criteria for the diagnosis using the DSM 9. What is a mixed affective episode? 10. Describe the differences between melancholic and atypical depressions 11. Describe the epidemiology of the different affective disorders. This should include lifetime prevalence (if you were taught it), typical age for first presentation, genetic components (if known), and gender differences (if there are any). 2 12. What life events predispose an individual to a depressive episode. 13. What life events predispose an individual to an acute stress disorder. 14. Name some symptoms of stress. 15. What are the somatic symptoms of anxiety? 16. What are the main differences between normal and pathological reactions to stress? 17. What are the worries, anxieties and fears typical of agoraphobia, panic attacks, and GAD? Disease mechanism 18. Draw a diagram of the HPA axis and explain what it is. 19. What evidence is there that the HPA axis is important in depression. 20. Explain how brain atrophy might be a causative factor in depression. Pharmacotherapy 21. Briefly explain the monoamine theory of affective disorders, including the neuroanatomical pathways. 22. Name as many of the drug classes that you can used for treating anxiety disorders. 23. For each drug class, name TWO examples of drugs. 24. For each of the above drugs or drug classes for treating anxiety disorders, name any notorious adverse effects and risks that the physician must be aware of before prescribing. 25. For each of the drug classes used to treat anxiety disorders, name some other indications that the drugs are used for. 26. Name as many of the drug classes that you can use for treating affective disorders. 27. For each of the drug classes for treating affective disorders, name the mechanism by which the drug works. 28. For each drug class, name TWO examples of drugs. 29. For each of the above drugs or drug classes for treating affective disorders, name any notorious adverse effects and risks that the physician must be aware of before prescribing. 30. For each of the drug classes used to treat affective disorders, name some other indications that the drugs are used for. Other therapies 31. Explain the process of cognitive therapy of depression. 32. Explain the role of the therapist in cognitive therapy of depression. 33. Explain the circumstances under which electroconvulsive therapy would be used. 3 34. Explain why electroconvulsive therapy is much safer than 20 years ago (ie why is it no longer similar to its frightful portrayals on television). Extra Questions 35. Explain the relevant neuroanatomy for fear conditioning. 36. What are the main differences in treating anxiety disorders with SSRIs vs. benzodiazepines, and what does that say about their modes of action. 4