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Type of anxiety disorder
What is the most prevalent pysch disorder
- lifetime prevalent rate is 14.6%
- young onset (chidhood-early adult)
- can hav somatic symptoms
- Can be debilitating
What must be considered to distinguish anxiety from a pathological anxiety
Pathological anxiety;excessiveness, irrationality, and physiological and/or functional impairment
Nonpathological is a regulated adaptive behavior
Which physiologocal systems has been associated with anxiety
OCD, pain disorder, and phobia
have been linked to genetic predisposition
Look for Family Hx of anxiety disorders.
PTSD and GAD
Is tributed to enviormental influences
- GAD=exposure in early childhood.
- PTSD= a significant event
S/S of anxiety
- chest pain or palpation
- nausea/vomiting/diarrhea= GI distress
- dialted pupil
Which medical condition can cause anxiety
Medication/drugs that can cause anxiety
- Methylphenidate (ritalin), aderal
- Social drugs
Think of any drugs that are stimulus can cause anxiety
20% of dx anxitey disorder abuse drug as attempt to self medicate.
Prior to diagnosing anxiety disorder based on s/s
Clinician must first r/o any and all possible pathological and pharmological causes before estabilshing this as the dx.
- Must r/o hypoxia, hypoglycemia.
- No drug causing condition (withdraw)
- Do toxicology study
Tretment of anxiety
- combination of medication and therapy is most effective.
- -SRRI (first line)
- tritrated to high dose than in depression
- -Benzodiazipine (concern of abuse)
- rapid response
- ideal with panic disorder with infrequent exposure
- -specfic phobia and in desentizing therapy
- -use with SSRI at beggining of therapy for coverage while SSRI is being titrated.
- -with SSRI if concern of benzo abuse or if needing to stop Ben and SSRI is inadequate
- -SSRI and Bus for GAD and social anxiety
- -slow acting (2-6 week) compared to Ben
Name the benzodiazepone and duration
- Alprazolam-xanax (short)
- Chloridiazepoxide-Librum (long)
- Clonazapam-Klonopin (long)
- Diazepam-Valium (long)
- Oxazepam-serax (short)
Reason of failure of anxiety therapy
- Failure to make diagnosis
- Inadequate treatment
Associated compliaction of anxiety disorder
- PTSD-sleep distrubance=functional impairment
- GAD-sleep distrubance=functional impairment
consider quality of life if anxiety is not regulated
Anxiety are at risk for depression, sub abuse, and suicide