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DISORDERS

PANIC DISORDER
SPECIFIC
PHOBIAS
AGORAPHOBIA
PHOBIAS
SOCIAL ANX.
DISORDER

DURATION/ONSET

SYMPTOMS/MANIFESTATIONS

TREATMENT

OBSESSIVE COMPULSIVE
DISORDER
(OCD)

DISORDERS DURATI ON/ONSET SYMPTOMS/MAN I F ESTATI ONS TR EATM ENT Anxiety D. Panic Disorder >1 month ABRUPT onset: recurrent periods of intense fear
discomfort peaking in 10 minutes with: P alpitations, P aresthesias. A bdominal distress. N ausea. I ntense fear of dying, Llghth headedness. C hills, C hoking,
disconnectedness, C hest pain. 5 ...veatin.g,S haking, 5 hortness of breath. Plus: persistent concern of additional attacks + worrying about its consequences + related
behavioral changes In acute situations: Alprazolam SSRI (V choice) TCAs: Irnipramine Clonazepam If hyperventilation: CO2 (breath in a paper bag) Keep la for 6-12m
Phobias Specific Phobias > 6months Anxiety when faced with identifiable object or situation_ Pt tries to avoid it_ Disabling fear Systematic desensitization. Assertiveness
training. Agoraphobia Fear of open spaces from which escape would be difficult in the event of panic symptom 5 S-ocial Anxiety Disorder Former Social Phobia_ Fear of
embarrassment in social situations_ Stage fright! SSRI Beta Mockers: stage fright Obsessive Compulsive Disorder (OCD) Body Dysrnorphic D. Obsession: intrusive
thought 3- ]contamination, rdoubt, guilt, aggression, sex, etc_ Compulsion: repetitive action rhand washing, rchecking, organizing, counting, praying, etc. Pt is EGO
DYSTONIC (they hate doing all the rituals} Frontal lobe: INCREASED metabolism Caudate nucleus: increased metabolism Erodv Dvsrnorphic Disorder Behavioral
psychotherapy: relaxation training, guided imagery, exposure & response prevention. SSRI: flume-tine, flu oxamine TCAs: Clomipramine SOCII Individual psychotherapy
Antidepressants. Pt truly believes that some part is abnormal, defective, or misshapen when NOT (e.g. facial flaws) 3 impairment in level of functioning. Constant mirrorchecking, hide "deformity", housebound, avoid social events. Acute Stress Disorder & Post- Traumatic Stress Disorder (PTSD) Acute > 2days, <1month PTSD >lrnonth Severe
anxiety symptoms followed by a threatening event that caused feelings of fear, helplessness or horror (right after or years after event. The sooner, the better the px) Reexperience of the event: recurrent dreams, flashbacks Phobic avoidance (pt was raped in school, pt drops out of school) Increased anxiety. Sleep disruption or excess.
Group therapy Constant counseling SSRIs improve functional level Antidepressants BZD Best choice: pharmacotherapy '(`REM Latency 4,Amount of REM I ,,I,Sta.ge 4
Adjustment Disorder < 6 months Maladaptative reactions to an identifiable psychosocial stressor Presence of IDENTIFIABLE STRESSOR (can't be grief) within 3 months of
onset Anxiety, depression or emotional turmoil with significant social, academic and/or occupational IMPAIRMENT Supportive psychotherapy Anxiolytics, antidepressants
Generalized Anxiety Disorder (GAD) > 6 months Excessive, poorly controlled anxiety about life circumstances. Physio & Psychological sx. Behavioral therapy: relaxation
training, biofeedback SSRI- SNI9.1: Venlafaxine Buspirone BZD Physiologic component Psychologic component Worry that's difficult to control Autonomic hyperactivity: *
shortness of breath * diaphoresis * tremor Hypervigilanc e Restlessness Sleep disturbances Difficulty concentrating Motor tension

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