Anxiety disorders are among the most prevalent psychiatric conditions and include disorders like generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder. Anxiety is characterized by feelings of fear, worry, and unease, often about vague future threats, and can cause physiological symptoms. It is considered pathological when the anxiety response is inappropriate in intensity or duration. Treatment options for anxiety disorders include cognitive behavioral therapy and medication.
Anxiety disorders are among the most prevalent psychiatric conditions and include disorders like generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder. Anxiety is characterized by feelings of fear, worry, and unease, often about vague future threats, and can cause physiological symptoms. It is considered pathological when the anxiety response is inappropriate in intensity or duration. Treatment options for anxiety disorders include cognitive behavioral therapy and medication.
Anxiety disorders are among the most prevalent psychiatric conditions and include disorders like generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder. Anxiety is characterized by feelings of fear, worry, and unease, often about vague future threats, and can cause physiological symptoms. It is considered pathological when the anxiety response is inappropriate in intensity or duration. Treatment options for anxiety disorders include cognitive behavioral therapy and medication.
Anxiety disorders are among the most prevalent psychiatric conditions and include disorders like generalized anxiety disorder, panic disorder, social anxiety disorder, and separation anxiety disorder. Anxiety is characterized by feelings of fear, worry, and unease, often about vague future threats, and can cause physiological symptoms. It is considered pathological when the anxiety response is inappropriate in intensity or duration. Treatment options for anxiety disorders include cognitive behavioral therapy and medication.
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Anxiety Disorders
What is anxiety?
distress or uneasiness of mind caused by fear of danger or misfortune FEAR vs ANXIETY an acute response to a a chronic response to threat that is a threat that is known, unknown, definite, vague, external and internal and non-conflictual conflictual
Emotional reaction to an Anticipation of future
external danger that leads to escape threat that leads to behaviors avoidance behavior NORMAL ANXIETY A DIFFUSE, UNPLEASANT, VAGUE SENSE OF APPREHENSION OFTEN ACCOMPANIED BY AUTONOMIC SYMPTOMS HEADACHE PERSPIRATION PALPITATIONS STOMACH DISCOMFORT RESTLESSNESS o CONSTELLATION TENDS TO VARY AMONG PERSONS
AN ALERTING SIGNAL
ENABLES ONE TO TAKE MEASURES VS THREAT NORMAL ANXIETY peripheral manifestations may include: - dizziness or light-headedness - palpitations / tachycardia - restlessness - upset stomach /diarrhea - syncope - urinary urgency / frequency - hypertension - tremors - hyperhidrosis - tingling in the extremities
the experience of anxiety has 2 components:
the awareness of the physiological sensations the awareness of being nervous or frightened Psychological and cognitive symptoms: (Anxiety affects thinking, perception, and learning) confusion distortion of perceptions of time, space, people, events poor concentration reduced recall impaired ability to make associations selectivity of attention What causes anxiety? Psychological theories:
Psychoanalytic theories Anxiety signals the presence of danger in the unconscious link the source of anxiety to developmental issues
Behavioral Theories anxiety as a conditioned response to specific stimuli learned by imitating the anxiety responses parents
Existential Theories anxiety as a person’s response to the awareness of his own nothingness and the seeming meaninglessness of his life Biological theories:
Neurotransmitters : NE, Serotonin, GABA
Brain imaging studies : large cerebral ventricles abnormalities in the frontal cortex, occipital and temporal areas, and ( for panic disorder) parahippocampal gyrus Genetic studies
Neuroanatomical considerations : Limbic system Cerebral cortex PATHOLOGICAL ANXIETY The anxiety response is inappropriate because of its intensity and duration
Lifetime prevalence rate
30.5% for women 19.2% for men Prevalence decreases with higher socio-economic status ANXIETY DISORDERS Among the most prevalent psychiatric conditions May increase the rate of cardiovascular-related mortality Persistently shown to produce excessive Morbidity Use of health care services Functional impairment
Treatments available are among the most effective in
psychiatric medicine Most patients should expect relief in a brief period ANXIETY DISORDERS DSM-5 classification 1. Separation Anxiety Disorder 2. Selective Mutism 3. Specific Phobia 4. Social Anxiety Disorder 5. Panic Disorder 6. Agoraphobia 7. Generalized Anxiety Disorder 8. Substance/Medication-Induced Anxiety Disorder 9. Anxiety Disorder Due to Another Medical Condition 10. Other Specified Anxiety Disorder 11. Unspecified Anxiety Disorder Anxiety Disorders Selective Mutism Refusal to verbally communicate outside of the home or with people other than immediate family/caregivers May communicate nonverbally (thru nodding or grunting) Affected children do not usually possess language deficits. Typically has an age of onset of under 5 years Often first noticed in school settings May result in social and academic impairment Separation Anxiety Disorder Has been moved from Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence (DSM-IV-TR) to the Anxiety Disorders (DSM-5)
The age-of-onset requirement (‘‘before age 18 years’’)
has been dropped; thus allowing for diagnosis of Separation Anxiety Disorder in adults
Duration of symptoms: at least 6 months in adults, at
least 1 month in children Separation Anxiety Disorder Developmentally inappropriate and excessive anxiety emerges related to separation from major attachment figure. May present as: Refusal to go to school ( a psychiatric emergency ) Fears and distress upon separation Physical symptoms when separation is anticipated Nightmares related to separation issues
Prevalence: 4 % in children 1.6% in adolescents; 0.9%-1.9% adults The most common anxiety disorder in childhood Most frequent age of onset : 7-8 years old Separation Anxiety Disorder Risk factors: life stress, especially loss parental overprotection and intrusiveness Increased risk of suicide in children
Differential Dx. : Dependent PD, Depressive and Bipolar D,
Oppositional Defiant D., Psychotic D. other Anxiety D
Comorbidity : with specific phobia and GAD
Treatment: cognitive-behavioral therapy, family education,
family psychosocial intervention, pharmacotherapy (SSRIs)
