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most common mental illness in the United States - Anxiety disorders
-Anxiety impacts approximately 18% of the adult population and 25% of children ages 13-17
each year
Obsessive-compulsive disorder (OCD) - characterized by persistent, uncontrollable
thoughts or actions that occur over an hour or more per day
-one of the top 20 illness-related disabilities worldwide
first line medication treatment: Generalized anxiety disorder - -SSRIs
-SNRIs
-Buspirone
-Drug Therapy at least 12 months
first line medication treatment: Panic disorder - -Paroxetine
-Sertraline
-Fluoxetine
-Drug therapy 6-9 months
first line medication treatment: Obsessive compulsive disorder - -Fluoxetine
-Fluvoxamine
-Sertraline
-Paroxetine
-Clomipramine (TCA)
-Drug therapy for at least 1 year
first line medication treatment: Social anxiety disorder - -Sertraline
-Paroxetine
,-Drug therapy takes 4 weeks to see effects
first line medication treatment: Post-traumatic stress disorder - -Paroxetine
-Sertraline
Anxiety is often comorbid with _________________ as well as medical conditions such as
____________, ___________, and ___________ - major depression, COPD, asthma,
diabetes
Generalized anxiety disorder (anxiety) - neurological condition
-characterized by persistent, uncontrollable worrying that causes emotional distress
-show symptoms on most days, for a period of at least six months
-common symptoms of anxiety include restlessness, irritability, muscle tension, fatigue, and
sleep disturbances
-GAD is twice as common in women as in men
Patients with anxiety disorders often show increased activity in the ______________ and
_______________ - amygdala and prefrontal cortex
Positron emission tomography (PET) scans have shown reduced ___________________ in
patients with anxiety - serotonin binding
Risk factors for developing anxiety: - -genetic predisposition (family history of anxiety)
-being female
-recent life stressors
-chronic physical illness
-lack of support during childhood
Anxiety Disorders - Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Panic
Phobias
Agoraphobia
Adjustment Disorder with Anxiety
, GAD often presents with physical symptoms, including: - restlessness or edginess
fatigue
difficulty concentrating
irritability
muscle tension
sleep disturbance
Functional neuroimaging studies of GAD show: - increased activation of the amygdala
and reduced activation in the prefrontal cortex, indicating heightened activation of the fear
response with diminished capacity for reasoning
Harold is a 32-year-old who presents to the clinic with complaints of fatigue, difficulty
concentrating, and difficulty falling asleep at night. He states he worries about finances, his
performance at work, and his relationship, and his worries have been "almost constant" for 8
months. He denies substance use and recently had a normal physical exam. He feels that his
relationship is suffering due to his constant worry.
Based on the DSM-5-TR, does Harold meet diagnostic criteria for generalized anxiety disorder? -
Yes
Rationale: Harold meets the following diagnostic criteria for generalized anxiety disorder: He
has three symptoms associated with worry, including fatigue, difficulty concentrating, and sleep
difficulties. He has experienced anxiety more days than not for over 6 months, and his worries
are impacting his relationship.
Social Anxiety Disorder - AKA social phobia
-condition in which typical, everyday social interactions cause significant anxiety, self-
consciousness, fear of embarrassment, or a feeling of being judged negatively by others
-may worry about the presence of physical symptoms that others may notice such as trembling
or blushing
-derealization, or a feeling of "spacing out," may occur
-Causes likely include a combination of genetic and environmental factors
-past year: 7% of adults and 9% of adolescents