Presented By : Abdul Salam .K.P. Chaired by : Mr.

Ravikesh Tripathi , Junior Consultant, Clinical Psychology

PHOBIC AND OTHER ANXIETY DISORDERS

Neurosis and Psychosis

Neurosis
Insight into illness Distinguish between subjective experiences and

reality Reasonable social adjustment

Psychosis
Lacks insight
Constructs a false environment out of

subjective experiences Whole personality being distorted Hysteria with grossly abnormal personality Schizophrenics still working

Phobic Anxiety Disorders

Well defined situations
Palpitations & fear of dying/losing

control/going mad Anticipatory anxiety Object external to the subject Coexists with depression

F40.0 Agoraphobia
Psychological or autonomic symptoms are primary At least two- crowds,public places,travelling

away from home,travelling alone Avoidance of the situation

F40.00 Without Panic Disorder F40.001 with Panic Disorder

(not a codable disorder in DSM)

F40.1 Social Phobias

Fear of scrutiny by other people
Discrete fears Fear of vomiting in the public

Blushing, hand tremors,nausea,urgency of micturition

May progress to panic attacks

Avoidance
If both social phobia and agoraphobia are

present,precedence to be given to agoraphobia

F40.2 Specific Phobias

Proximity to particular animals,heights,closed spaces,sight of blood
May evoke panic

Differentials:
Hypochondriacal disorder Delusional disorder

Dysmorphophobia

DSM duration 6 month if <18 yrs;diff. types specified.

 F40.8 Other Phobic Anxiety

Disorders
F40.9 Phobic Anxiety Disorder,

Unspecified

F41 Other Anxiety Disorders

Panic disorder
Generalized Anxiety Disorder Mixed Anxiety-Depressive Syndrome Other Mixed Anxiety Disorders Other Specific Anxiety Disorders

F41.0 Panic disorder

Not restricted to any particular situation
Palpitations,chest pain,choking

sensations,depersonalisations and derealisations Fear of dying/going mad Avoidance due to fear of recurrence of attack

 Diagnostic guidelines
If a manifestation of phobia,it should be given the

precedence. Several attacks within around 1 month In situations where there is no objective danger. Unpredictable No anxiety symptoms between attacks

DSM At least four symptoms Anx. Should peak within 10 min.

Duration 1 month
Not due to sub. abuse or GMC

F41.1 Generalized Anxiety Disorder

Free-floating anxiety
Must last for most days for several weeks
Apprehension

Motor tension
Autonomic over activity

DSM 6 months, at least 3 sympt. ,difficult to control

worry

F41.2 Mixed Anxiety Depressive Disorder

Neither anxiety or depression is severe
Autonomic symptoms must be present If associated with life events, adjustment

disoredr should be made

 F41.3 Other Mixed Anxiety Disorders

GAD + Other Symptoms

F41.8 Other Specified Anxiety Disorders

Like Anxiety Hysteria

F41.9 Anxiety Disorders, Unspecified