BCPP- Anxiety Review Questions with Answers

Timeframe for GAD diagnosis 6 months # of symptoms needed for GAD diagnosis 3 GAD symptoms restlessness fatigue poor concentration irritability muscle tension sleep disturbance These rating scales for GAD are self-rated GAD-7, Beck Anxiety Inventory, PSWQ, Zung SAS Rating scale for GAD that is clinician-rated HAM-A Cut-offs for GAD-7 0-5 = mild 6-10 = moderate 11-15 = severe Cut-offs for HAM-A 0-17 = mild 18-24 = moderate 25-30 = severe 70% reduction or score 7 = remission 50% reduction = response 25% = non-response This rating scale distinguishes between anxiety/depression and is more specific for panic symptoms Beck Anxiety Inventory These herbal products can cause anxiety High dose ginseng St. John's Wort Kava Noradrenergic GAD model: locus coeruleus acts as the panic button and stimulates release of ___ in response to fear as well as the PNS and SNS. This is hypersensitive (chronic), resulting in downregulation of ___. The stress response causes release of ___ from the hypothalamus. This binds to the anterior pituitary and increases ____, which acts at the adrenal cortex to release glucocorticoids, including ____. This is known as the ____. NE; alpha 2 adrenoreceptors; corticotropin releasing factor (CRF); adrenocorticotropin hormone (ACTH); cortisol; hypothalamic-pituitary-axis (HPA) GAD Treatment guidelines -first line -no response -second line -augmentation: SSRIs (escitalopram, paroxetine, sertraline), CBT, combo (unclear if more efficacious) switch SSRI, duloxetine, venlafaxine XR, pregabalin BZDs (for acute treatment), buspirone, hydroxyzine, SGA, BZD, antihistamine, buspirone, pregabalin