Non-Specific Exam Findings: Panic Disorder
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Chest Pain, Numbness and Parasthesias, SOB - Patients present to ER often
mistaking the panic attack for a MI
MSE: High level of anticipatory anxiety between panic episodes; findings
are pronounced during panic episodes and less pronounced during non-
panic periods.
Clinical Management: Social Anxiety
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, Pharmacological: SSRIs, Benzos (Short-Term), BB (used for discrete
episodic relief) - NO TCAS!
Non-pharmacological: CBT, Exposure Therapy, Relaxation Therapy
Assessment
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Individual may have more physical S/S and not identify anxiety as the CC
Subjective complaint of nervousness, tense, worry, and stress
Identify individual's environmental stressors
Interferes with social, occupational, and recreation activities and ADLs
Use standardized rating scales - HAM-A
Levels of Anxiety: Mild
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Normative level, can be MOTIVATING
NL VS
Perceptual field BROADENED
Heightened awareness of the environment
Social Anxiety Disorder
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, M=F
Marked fear or anxiety about ONE or MORE situations in which the
individual is exposed to possible scrutiny by others
Social phobia should be diagnosed if symptoms persist LONGER THAN 6
MOS
Estimated 3-13% prevalence rate in the US
Descriptive features:
- Oversensitive to criticism
- Negative self view
- Sensitive to rejection
- Low self-esteem
- Feelings of inferiority
- Lack assertiveness
- Anticipatory anxiety can occur days to weeks before the feared social
situation
Onset in mid-teens, often following stressful or humiliating experience and
tends to remit with age
GAD Etiology and Pathophysiology
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Etiology and Pathophysiology are POORLY UNDERSTOOD.
Probably caused by combination of environmental factors and genetic
predisposition
Pathophys involves abnormalities in NE, SE, and GABAa- BZ system.
Pharmacological Management: SSRIs
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Give this one a try later!
Chest Pain, Numbness and Parasthesias, SOB - Patients present to ER often
mistaking the panic attack for a MI
MSE: High level of anticipatory anxiety between panic episodes; findings
are pronounced during panic episodes and less pronounced during non-
panic periods.
Clinical Management: Social Anxiety
Give this one a try later!
, Pharmacological: SSRIs, Benzos (Short-Term), BB (used for discrete
episodic relief) - NO TCAS!
Non-pharmacological: CBT, Exposure Therapy, Relaxation Therapy
Assessment
Give this one a try later!
Individual may have more physical S/S and not identify anxiety as the CC
Subjective complaint of nervousness, tense, worry, and stress
Identify individual's environmental stressors
Interferes with social, occupational, and recreation activities and ADLs
Use standardized rating scales - HAM-A
Levels of Anxiety: Mild
Give this one a try later!
Normative level, can be MOTIVATING
NL VS
Perceptual field BROADENED
Heightened awareness of the environment
Social Anxiety Disorder
Give this one a try later!
, M=F
Marked fear or anxiety about ONE or MORE situations in which the
individual is exposed to possible scrutiny by others
Social phobia should be diagnosed if symptoms persist LONGER THAN 6
MOS
Estimated 3-13% prevalence rate in the US
Descriptive features:
- Oversensitive to criticism
- Negative self view
- Sensitive to rejection
- Low self-esteem
- Feelings of inferiority
- Lack assertiveness
- Anticipatory anxiety can occur days to weeks before the feared social
situation
Onset in mid-teens, often following stressful or humiliating experience and
tends to remit with age
GAD Etiology and Pathophysiology
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Etiology and Pathophysiology are POORLY UNDERSTOOD.
Probably caused by combination of environmental factors and genetic
predisposition
Pathophys involves abnormalities in NE, SE, and GABAa- BZ system.
Pharmacological Management: SSRIs
Give this one a try later!
