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Psychiatry pro +1700 > OCD and such > Flashcards

OCD and such Flashcards

1
Q

What is fear?

A

the physical and mental response to an imminent threat

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2
Q

What is anxiety?

A

The anticipation of threat in the future

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3
Q

Anxiety or fear: threat is known

A

Fear

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4
Q

Anxiety or fear: desire to escape

A

Fear

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5
Q

Anxiety or fear: desire to avoid

A

Anxiety

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6
Q

Anxiety or fear: muscle tension and vigilance

A

Anxiety

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7
Q

Anxiety or fear: fight/flight/freeze response

A

Fear

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8
Q

True or false: both anxiety and fear can occur as part of anxiety disorders

A

True

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9
Q

What is the most common category of mental disorders?

A

Anxiety disorders

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10
Q

What is the prevalence of anxiety disorders every year?

A

18%

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11
Q

Are anxiety disorders more common in women or men?

A

Women

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12
Q

True or false: anxiety disorders tend to develop in adulthood

A

False–childhood

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13
Q

What is the classic course of GAD?

A

Chronic, waxing and waning course

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14
Q

What does avoidance lead to? Exposure?

A

Avoidance - Anxiety

Exposure - Extinction

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15
Q

What is the lifetime prevalence of anxiety disorders in women? Men?

A 
Women = 30%
Men = 19%
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16
Q

What are the comorbidities of anxiety disorders?

A

Depression and substance abuse

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17
Q

What are the 4 criteria for specific phobias?

A
  • Marked fear or anxiety about a specific object
  • Exposure to the phobic stimulus provokes immediate fear
  • The phobic object is avoided
  • Fear is out of proportion to the actual danger
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18
Q

How long do phobias last for, (to meet the criteria)?

A

6 months

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19
Q

True or false: most people with a phobia usually do not have more than one

A

False–most do

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20
Q

In what age group are phobias particularly prevalent in?

A

Adolescents

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21
Q

True or false: excessive fears are common in young children, and often transitory–thus consider it part of normal development

A

True

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22
Q

What is the major difference between phobias and realistic fears?

A

Realistic fears are proportional to probability

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23
Q

What is the best treatment for fear?

A

Exposure therapy

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24
Q

What is the one exception to increased SNS with phobias?

A

Sight of blood

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25
Q

Is pharmacotherapy recommended for treatment of phobias? Why or why not?

A

No–treatment gains are not sustained

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26
Q

How long does exposure therapy have to last for?

A

until fear decreases

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27
Q

When is pharmacotherapy appropriate for phobias?

A

For one time instances (flying for one time, vs flying constantly for new job)

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28
Q

What are the criteria for social anxiety disorder? (5)

A
  • Marked fear/anxiety of social situations
  • Concern for acting in a way that is humiliating
  • Exposure to social situations
  • Feared situation is avoided
  • Fear/anxiety is out of proportion
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29
Q

What is the time duration that is needed to diagnose social anxiety disorder?

A

6 months or more

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30
Q

What is the CBT treatment for social anxiety disorder?

A
  • Correction of maladaptive thinking

- Exposure to feared social situations

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31
Q

Can CBT for social anxiety disorder be done in groups?

A

Yes

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32
Q

What is the pharmacotherapy for social anxiety disorder? (4)

A
  • SSRIs/SNRIs
  • Beta blockers
  • MAOIs
  • Benzos
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33
Q

Performance based anxiety disorders respond well to what sort of pharmacotherapy?

A

Beta blockers

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34
Q

What is panic disorder?

A

Recurrent, unexpected panic attacks (abrupt surge or intense fear or discomfort within minutes)

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35
Q

How many symptoms are needed to diagnose a panic attack?

A

4+

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36
Q

What is the anxiety component of panic disorders?

A

Persistent worry about additional attacks or their consequences, resulting in maladaptive change in behavior related to the attacks

37
Q

Is a single episode of a panic attack diagnostic for a panic disorder?

A

No–need multiple

38
Q

What is the ratio of panic attacks in females:males?

A

2:1

39
Q

What is the median age at onset of panic attacks?

A

early 20s

40
Q

Can panic attacks occur during sleep?

A

Yes–need to have one for diagnosis of panic disorder

41
Q

There is a (__)x increase in mental disorders in first degree relatives of panic attack pts.

A

4-8x

42
Q

True or false: syncopal episodes do not happen with panic attacks, and should be worked up medically

A

False

43
Q

What is the first line treatment for panic attacks?

A

CBT and panic-focused psychodynamic psychotherapy

44
Q

What are the pharmacotherapies for panic attacks?

A
  • SSRIs/SNRIs
  • TCAs
  • Benzos
45
Q

True or false: pts with panic disorders are often intensely sensitive to side effects of medications

A

True

46
Q

What is agoraphobia, and what are the 5 diagnostic criteria?

A

Marked fear or anxiety about at least 2 of the following:

  • Using public transportation
  • Being in open spaces
  • Being in enclosed spaces
  • Standing in line or being in a crowd
  • Being outside the home alone
47
Q

What is the fear of agoraphobia usually d/t?

A

Not having access to help or of not being able to escape the situation

48
Q

How long do s/sx of agoraphobia have to last for to meet the criteria for diagnosis?

A

6 months

49
Q

True or false: agoraphobia often develops as a result of panic disorders

A

True

50
Q

What age group is the incidence of agoraphobia the highest?

A

adolescence

51
Q

What is the treatment for agoraphobia?

A

CBT or SSRIs

52
Q

True or false: SSRIs are generally safe in overdose

A

True

53
Q

Which type of antidepressant is more effective in the treatment in panic/agoraphobia

A

TCAs

54
Q

What is the criteria for GAD? (2)

A
  • Excessive anxiety/worry for more days than not for at least 6 months about a number of events or activities
  • Difficulty controlling the worry
55
Q

When (age wise) is the peak incidence of GAD?

A

Middle age

56
Q

GAD is more common in men or women?

A

Women

57
Q

True or false: GAD s/sx tend to wax and wane

A

True

58
Q

What is the treatment for GAD?

A
  • CBT

- Acceptance and commitment therapy

59
Q

What are the components of the acceptance and commitment therapy? (3)

A
  • Decrease avoidance
  • Decrease attachment to thoughts
  • Increase behavior moving towards valued goals
60
Q

What is the pharmacotherapy for GAD?

A
  • SSRIs/SNRIs
  • Benzos (acutely)
  • Buspirone
61
Q

What is the MOA of buspirone?

A

serotonin 5-HT1A receptor partial agonist

62
Q

What is the MOA of benzos?

A

Increases Cl channel opening frequency

63
Q

What is the MOA of barbiturates?

A

Increases Cl channel opening duration

64
Q

True or false: relapse is common in GAD in the first year after discontinuation of medication

A

True

65
Q

What are obsessions?

A
  1. Recurrent, intrusive and unwanted thoughts

2. Attempts are made to suppress, ignore or neutralize them with some other thought

66
Q

What are compulsions?

A
  1. Repetitive behaviors or mental acts that one feels driven to perform in response to an obsession
  2. Behaviors or mental acts are aimed at preventing or reducing anxiety
67
Q

What is characteristic of the compulsions with OCD?

A

The behaviors or mental acts are aimed at preventing or reducing anxiety or distress or preventing some dreaded event/situation, but they are not connected in any realistic way with what they are designed to neutralize or prevent, or are clearly excessive

68
Q

What are the characteristics of obsessive thoughts?

A

Not pleasurable or voluntary–feel intrusive and undesired

69
Q

What is the usual level of insight with OCD?

A

Variable

70
Q

What is the mean age of onset for OCD? Course?

A

Mean age of onset is 20

Chronic, waxing and waning but 40% are self-limited

71
Q

What is the usual comorbidity with OCD?

A
  • Tic disorders
  • Depression
  • Other anxiety disorders
72
Q

What is the treatment for OCD?

A

-Behavior therapy

73
Q

What is the pharmacotherapy for OCD?

A
  • SSRIs/SNRIs

- Clomipramine

74
Q

Are benzos effective for OCD?

A

No

75
Q

What are the criteria for OCD?

A

Need to take up at least an hour of the day or cause significant distress or impairment

76
Q

What SSRI is particularly efficacious in treating OCD?

A

Clomipramine

77
Q

What is body dysmorphic disorder?

A

Preoccupation with a perceived defect or flaw in appearance not observed by others
-Has a performed, repetitive behavior in response

78
Q

True or false: there is usually little insight with body dysmorphic disease?

A

True

79
Q

True or false: the risk of suicide is not elevated in body dysmorphic disorder, as compared to general population

A

False

80
Q

What is the treatment for body dysmorphic disorder?

A
  • SSRIs

- CBT

81
Q

What are the diagnostic criteria for hoarding?

A
  • Persistent difficulty discarding/parting with things, regardless of their value
  • Perceived need to save, and distress associated with discarding
82
Q

Hoarding is more common among what age group?

A

Old people

83
Q

True or false: there is a strong genetic component to hoarding

A

True

84
Q

What is the treatment for hoarding?

A

CBT (maybe)

85
Q

What is trichotillomania?

A
  • Recurrent pulling out of hair for gratification

- Repeated attempts to stop

86
Q

When does Trichotillomania usually begin?

A

Around puberty

87
Q

What is the treatment for Trichotillomania?

A

Psychotherapy and habit reversal therapy

88
Q

What is excoriation disorder?

A
  • Recurrent skin picking resulting in lesions

- Repeated attempts to stop

89
Q

What is the treatment for excoriation disorder?

A

Psychotherapy

Psychiatry pro +1700 (28 decks)

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