Panic Disorder with/without Agoraphobia Specific Phobia Social Phobia Obsessive Compulsive Disorder...

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Panic Disorder with/without Agoraphobia Specific Phobia Social Phobia Obsessive Compulsive Disorder (OCD) Generalized Anxiety Disorder (GAD) Post Traumatic Stress Disorder (PTSD) The DSM-IV Anxiety Disorders

Transcript of Panic Disorder with/without Agoraphobia Specific Phobia Social Phobia Obsessive Compulsive Disorder...

Page 1: Panic Disorder with/without Agoraphobia Specific Phobia Social Phobia Obsessive Compulsive Disorder (OCD) Generalized Anxiety Disorder (GAD) Post Traumatic.

Panic Disorder with/without Agoraphobia

Specific Phobia

Social Phobia

Obsessive Compulsive Disorder (OCD)

Generalized Anxiety Disorder (GAD)

Post Traumatic Stress Disorder (PTSD)

The DSM-IV Anxiety Disorders

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Discrete period of intense fear/discomfort in which at least 4 symptoms developed abruptly and reached a peak within 10 minutes

• palpitations, pounding/racing heart

• sweating

• trembling/shaking

• shortness of breath/smothering sensations

• feeling of choking

• chest pain/discomfort

• nausea or abdominal distress

• feeling dizzy, unsteady, faint or lightheaded

• derealization or depersonalization

• fear of losing control or going crazy

• fear of dying

• paresthesias (numbness or tingling sensations)

• chills or hot flushes

Criteria for a Panic Attack

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• recurrent, unexpected panic attacks

• AND one month of concern about additional attacks

• OR... worry about the implications of the attack or its consequences

• OR... a significant change in behaviour related to the attacks

Panic Disorder

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• anxiety about being in places/situations from which escape might be difficult or embarrassing in the event of a panic attack

• situations are avoided or endured with marked distress or anxiety about having a panic attack OR require the presence of a companion

Agoraphobia

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Specific Phobia

• marked and persistent fear that is excessive or unreasonable, cued by a specific object or situation

• exposure to the phobic stimulus almost invariably provokes an immediate anxiety response (e.g., a panic attack)

• phobic situation/object is avoided or endured with intense anxiety and distress

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Specific Phobia - Types

1. Animal

2. Natural Environment (e.g., heights, water)

3. Blood-Injection-Injury Type

4. Situational (e.g., planes, elevators, driving)

5. Other (e.g., choking, vomiting)

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Social Phobia

• marked and persistent fear of social or performance situations

• situations involve exposure to unfamiliar people or to possible evaluation by others

• individual fears that he/she may do something humiliating or embarrassing.

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• recurrent and persistent obsessions and/or compulsions • symptoms cause marked distress• time consuming (more than 1 hour/day)• interfere significantly with person’s normal routine

Obsessive-Compulsive Disorder

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OBSESSIONS

• persistent and intrusive thoughts, impulses, images • inappropriate, cause marked anxiety or distress• person usually attempts to ignore or suppress them • ...OR neutralize them with some other thought or action

COMPULSIONS

• repetitive behaviors or mental acts • performed to prevent or reduce anxiety/distress, not to provide pleasure or gratification

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Mood Disorders

Lifetime prevalence rates of depressive disorders:

13% men

25% women

Lifetime prevalence rates of bipolar disorders:

less than 1% for men and women

15% complete suicide

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DSM-IV Mood Disorders

Major D epressive D isorder Dysthym ic D isorder

Unipolar Depression

B ipolar I D isorder B ipolar II D isorder Cyclothym ia

B ipolar D isorder

M ood D isorders

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Mood Episodes

1. Major Depressive Episode

2. Manic Episode

3. Hypomanic Episode

4. Mixed Episode

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1. Major Depressive Episode

- Depressed mood- Loss of interest (anhedonia)- Significant weight loss or gain- Insomnia or hypersomnia- Psychomotor agitation or retardation- Fatigue or loss of energy- Worthlessness or guilt- Diminished ability to concentrate, indecisiveness

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2. Manic Episode - Abnormally and persistently elevated, expansive, or

irritable mood- Inflated self-esteem and grandiosity- Requiring very little sleep- Talkativeness- Flight of ideas- Distractibiltiy- Psychomotor agitation- Buying sprees, sexual indiscretions, foolish business

investments

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3. Hypomanic EpisodeSymptoms are milder than a Manic Episode

• Less intense and last at least four days

4. Mixed EpisodeBoth a Major Depressive Episode and a

Manic Episode nearly everyday for at least a one week period

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Major Depressive Disorder• One or more Major Depressive Episodes• No history of Manic, Hypomanic or Mixed Episodes

Dysthymic Disorder• Less severe but more chronic than Major Depressive Disorder• Symptoms are milder but remain unchanged over long periods of time

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Bipolar I Disorder• One or more Manic or Mixed Episodes • Often individuals have also had one or more

Major Depressive Episodes

Bipolar II Disorder• Presence (or history) of one or more Major

Depressive Episodes • Presence (or history) of at least one

Hypomanic Episode• There has never been a Manic Episode or a

Mixed Episode

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Cyclothymic Disorder

• Less severe but more chronic than Bipolar Disorder

• Symptoms of hypomania and depression are milder but remain unchanged over long periods of time

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DSM-IV Specifiers

1. Chronic2. Psychotic3. Melancholic4. Atypical5. Catatonic6. Postpartum Onset7. Seasonal Pattern8. Rapid Cycling Pattern

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Eating Disorders

• Females 10 x more likely to develop an eating disorder

• Around 5% of young women will develop an eating disorder

• Course and outcome of eating disorders is highly variable

• Eating disorders are associated with serious complications, and have the highest mortality rate

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DSM-IV Diagnostic criteria for Anorexia Nervosa

A. Low body weight

B. Fear of gaining weight or becoming fat

C. Weight-related self-evaluation, or denial of the seriousness of the low body weight

D. Amenorrhea

RESTRICTING TYPE

BINGE EATING/PURGING TYPE

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DSM-IV: Diagnostic criteria for Bulimia Nervosa

A. Binge eating

B. Inappropriate compensatory behavior

C. Both occur, at least 2/ week for 3 months

D. Weight-related self-evaluation

PURGING TYPE

NON PURGING TYPE

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Physical Complications

• Menstrual Dysfunction

• Hypothermia• Hypotension• Tiredness, Lethargy• Headaches• Hair Loss• Dental Problems

• Electrolyte Abnormalities

• Parathesias• Acute Gastric Dilation• Delayed Gastric

Emptying• Constipation• Swollen salivary gland• Kidney Dysfunction

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Psychological Complications

• Depression• Anxiety• Mood swings • Food Preoccupation

• Social Isolation• Sleep Disturbances• Self-Esteem Deficits• Impulsive Behaviors

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Schizophrenia

• Delusions and Irrational thought• Deterioration of Adaptive Behaviors• Hallucinations• Disturbed Emotion• Paranoid, Catatonic, Disorganized,

Undifferentiated• Positive vs. Negative symptoms • Chronic, resistant to treatment