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MHD & Therapeutics And Now Here Is The Host . . . is proud to present Dr. Schilling The categories for today’s Jeopardy on Anxiety Disorders will be: Trauma & Stress GAD & Panic Phobias Diagnosis Miscellaneous Trauma & Stress GAD & Panic 100 100 100 100 100 200 200 200 200 200 300 300 300 300 300 400 400 400 400 400 500 500 500 500 500 600 600 600 600 600 700 700 700 700 700 800 800 800 800 800 900 900 900 900 900 Phobias Diagnosis Miscellaneous What is depersonalization? Seen in ASD and PTSD, an experience of feeling as if one were an outside observer of one’s mental processes or body is this Row 1, Col 1 What is a flashback? Seen in ASD and PTSD, a reaction where the individual feels or acts as if the traumatic event were recurring 1,2 What is PTSD? About 50% of patients with Acute Stress Disorder go on to develop this disorder 1,3 What is rape? Highest rates of PTSD is seen in survivors of military combat, captivity, and this 1,4 What is prazocin (minipress)? Alpha blocker An anti-hypertensive medication shown to be useful in the treatment of nightmares in PTSD is this 1,5 What is arousal symptoms? In PTSD, sleep disturbance, irritability/anger, hypervigilance, concentration, and exaggerated startle response are all seen in the criteria category 1,6 What are benzodiazepines? While various antidepressant classes (SSRI’s, SNRI’s, even TCA’s, MAO-I’s)- are commonly used in treating PTSD, this class of nonantidepressant medication is NOT recommended 1,7 What is substance use disorders? Common co-morbid disorders with PTSD include mood disorders, anxiety disorders, and, especially in males, this 1,8 What is Avoidance Symptoms? The 4 PTSD symptom categories includes: Intrusion symptoms, Negative alterations in cognition & mood, Arousal symptoms, and this 1,9 What is agoraphobia? Patients diagnosed with Panic disorder are often also diagnosed with comorbid GAD but are most likely to be diagnosed with co-morbid this 2,1 What is substance use disorders? In♀ with GAD, co-morbidity is mostly other anxiety disorders & unipolar depression; In ♂with GAD, co-morbidity is mostly this 2,2 What is GAD? Of all the anxiety disorders, the one with the latest median age of onset is this 2,3 What is waxing & waning? Without treatment, the course of Panic Disorder, more so than GAD, is usually this 2,4 What is unexpected? For a panic attack to be part of panic disorder the attacks must be recurrent, result in persistent concern of more attacks, and this 2,5 What is SSRI’s & SNRI’s? Theses two medication classes are generally most effective in long term monotherapy treatment of GAD 2,6 What is age 45y/o? Due to age related dampening of the autonomic nervous system, Panic disorder appears to recede later in life, and usually will not start after this age 2,7 What is female? For both GAD and Panic disorder, as well as Anxiety disorders overall, the prevalence is greater in this sex 2,8 What is Bupropion (Wellbutrin)? While most antidepressants are used in treatment, for Panic Disorder and probably also GAD, it is not recommended to use this antidepressant 2,9 What is 3? 75% of patients with Specific Phobia have >1 phobia and the average Specific Phobia patient has this many 3,1 What are women? Animal, natural environment, & situational phobic stimulus are predominantly experienced by this sex 3,2 What is Situational? Situational Natural environment Animal Blood-injection-injury ============================== This phobia tends to have a later age of onset than the others 3,3 What is late childhood/early teen years? Age 8-15 Social phobias age of onset, 75% of the time, occurs during this time of life 3,4 What is blood-injection-injury? This specific phobia which is highly familial and elicits a strong vasovagal response is experienced nearly equally by both males and females 3,5 What is blushing? The hallmark physical response of an individual with Social Anxiety Disorder is this 3,6 What is 6 months? For both Specific Phobia and Social Phobia, the arbitrary time criteria is this 3,7 What is propranolol? A -blocker that may be used in the treatment of the performance anxiety subtype of Social Phobia is this 3,8 What is childhood? Mean age 10 Specific phobias usually develop during this time of life 3,9 What is panic disorder? Recurrent, untriggered, abrupt surge of intense fear followed by anticipatory anxiety that it will happen again is this 4,1 What is is Selective Mutism? An anxiety disorder that is relatively rare, equally common in males & females, and more likely to present in young children (<5 y/o) than adults is this 4,2 What is specific phobia? Anxiety or fear of animals/insects or the natural environment is this 4,3 What is Separation Anxiety? Excessive fear that leads to clinging or shadowing behavior towards the attachment figure (usually a parent) is this 4,4 What is Generalized Anxiety Disorder? Persistent and excessive anxiety and worry about various domains, including work or school performance, that the individual finds difficult to control 4,5 What is panic attack? Abrupt intense fear with symptoms that may include trembling, nausea, palpitations, and sweating is this 4,6 What is social phobia? Excessive anxiety from feeling scrutinized such as when meeting new people or in a situation of being observed eating or drinking in a public place is this 4,7 What is agoraphobia? Fear that help may not be available or escape may be difficult in situations such as using public transportation, being in an open or enclosed space, standing in line, or being in a crowd is this 4,8 What is Generalized Anxiety Disorder? In addition to anxiety, the individual has physical symptoms including restlessness, being keyed up or on edge, easily fatigued, trouble concentrating or mind going blank, irritability, muscle tension, and sleep disturbance in this 4,9 What is fear, anxiety? An emotional response to a real or perceived threat is this, whereas anticipation of a future threat is that 5,1 What is Adjustment Disorder? Symptoms begin within 3 months of the stressor and end within 6 months of the resolution of the stressor in this 5,2 What is Anxiety? Fear or Anxiety ======================= Muscle tension, vigilance in preparation for future danger, cautious or avoidant behaviors are associated with this 5,3 What is a compulsion? In order to neutralize the anxiety caused by an obsession, the person feels driven to do something which is called this 5,4 What is fear? Fear or Anxiety ============================ Surges of autonomic arousal, thoughts of immediate danger necessary for fight or flight, and escape behaviors are associated with this 5,5 What is an anxiety disorder? OCD is highly co-morbid with 30% having a lifetime tic disorder, 60% having a lifetime mood disorder, and 75 % having this 5,6 What is SSRI’s? In general, while many antidepressants are used in treating most anxiety disorders, the class that is the 1st choice is this 5,7 What is medical conditions? Before diagnosing an anxiety disorder, it is important to rule out substance induced causes and to rule out this 5,8 What is dirt/contamination? While doubts are very common obsessions, the most common obsessions in OCD is this 5,9