Psychiatry: Anxiety, Somatic, and Sleep Disorders

A discrete period of intense fear or discomfort in the absence of real danger that is accombined by at least 4 of 13 somatic or cognitive symptoms

3 Types of Panic Attacks

Anxiety about, or avoidance of places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having a Panic Attack or panic-like symptoms

Neither panic attacks nor agoraphobia are

Symptoms of a panic attack reach a peak within

Type of panic attack:
Occurs spontaneously or "out of the blue"

Type of Panic Attack:  Invariably occurs immediately on exposure to, or in anticipation of, the situational cue or trigger

Type of Panic Attack:
No invariably associated with the cue and do not necessarily occur immediately after the exposure

2 Symptoms that Panic Disorder Without Agoraphobia must have

If something is generating your panic attacks, it is NOT

Name the 3 DSM-IV diagnoses with panic attacks and agoraphobia

Clinically significant anxiety that is provoked by exposure to a specific feared object or situation.

Clinically significant anxiety that is provoked by exposure to certain types of social or performance situations, often leading to avoidance (Fear of embarrassment and negative assessment)

The development of a characteristic set of symptoms after exposure to an extreme traumatic stressor which the pt. responded w/ intense fear, helplessness, or horror. 

Obsessions or compulsions that are severe enough to be time consuming or cause marked distress/ significant impairment.  Pt. recognizes that the obsessions or compulsions are excessive or unreasonable.

Persistent ideas,thoughts impulses or images that are experience as intrusive and inappropriate and that cause marked anxiety or distress

Repetitive behaviors (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress

Excessive anxiety and worry occuring more days than not for a period of at least 6 months.

Clinically significant anxiety that is judged to be due to the direct physiological effects of a general medical condition

Somatoform Disorders

Disorder         Control      Motivation
Somatoform       U                 U
Factitious           C                 C
Malingering        C                 C   

Multiplicity of complaints and multiple organ systems affected

Preoccupation w/ fear of having a serious disease, no medical cause can be found

Intentional production of signs and symptoms of illness; only apparent motivation is to assume the role of a patient

Intentional production of false or grossly exaggerated symptoms motivated by external incentive

One or more neurologic symptoms preceded by conflict or other stressors

Preoccupation with an imaginary bodily defect or an exaggerated distortion of a minor defect

Pain that is not fully accounted for by a nonpsychiatric medical condition

Sleep Stages and waves

K complexes and sleep spindles are found in what stage of sleep

Normal Sleep Stage Percentages

DSM-IV Sleep Disorders

Characterized by abnormal behavioral or physiological events occuring in association w/ sleep, specific sleep stage, or sleep-wake transitions.

Disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amnt, quality, or timing of sleep

Name 3 Parasomnias

Name 5 Dyssomnias

Reptitive episodes of upper airway obstruction that occur during sleep.  Present with:
Snoring
Observed pauses in breathing when sleeping
Excessive daytime sleepiness

Narcolepsy is characterized by

Narcolepsy is associated with deficits in

Sleep-related Enuresis:

4 Tx's for Sleep-related Enuresis

Stage of Sleep:  Obstructive Sleep Apnea

Stage of Sleep:  Sleepwalking, sleep terrors

Stage of Sleep:  Periodic Limb Movment

Stage of Sleep:  Nightmare disorder, REM behavior disorder

Multiple sleep latency test

Sleep changes with aging