Week 2: Anxiety Disorders (OCD (Experience of obsessional thoughts.…
Week 2: Anxiety Disorders
Old WHO anxiety disorder ka problem ye tha ke abh neurosis mein organic abnormality ka evidence hai. It has a disapproval wali tone- stigma. Neurosis ka word abh use nei hota.
Common Mental Disorder
or minor mental disorder or major mental disorder like psychosis
Neurotic disorders kon se hain: depression, anxiety, ocd, stress or adjustment disorders
State vs trait
Hidden morbidity- kuch cases miss ho jatay hain.
women higher incidence
widows, lone parents, one person family, lower education, economically inactive, rentals mein rehnay walay, urban areas mein rehnay walay
Prolonged ya delayed response to a stressor
Flasbacks, recurring nightmares, vivid memories, emotional numbness and uss event ki yaaddaasht thori kum ho jati hai. Autonomic arousal, insomnia, irritability, hyper vigilance.
20-30% accident victims. Comorbidity
Management: Trauma-focused cognitive therapy, victim support groups. EMDR eye movement desensitisation and reprocessing. Medication if therapy doesn't work.
Prognosis is the course of a medical condition. Can become chronic.
Experience of obsessional thoughts. Repetitive. Reduces anxiety associated with the thoughts. Violent
1% in people with male=female
Onset in early adulthood. 20% ko kuch degree tak ho sakta hai.
Eating disorders- rituals,
4% schizophrenics can experience ocd
Organic brain disorders 9reduced brain function) vs compulsions
Biological aetiology: PET scans show increased activity in cingulate region, head of the caudate nuclei and orbital gyri.
Psychosocial: obsessional personality disorder kuch hota hai jo ke ocd ko precede kar jata hai onset mein but inn lougon mein depression zyada common hota hai. Lekin saray ocd people ki obsessional personality type.
: BT, CBT, response prevention and thought stopping.
Prognosis: fluctuating course. Relapse under stress.
NB anxiety is normal- New Brunswick
Overactivity of the sympathetic nervous system
Worrying about unrealistic threats/fears- pathological cognition
The Yerkes-Dodson Curve
Generalised anxiety D, panic D, agoraphobia, social P, specific P.
: anxiety is triggered in well defined situations.
: away from home in places that are difficult to leave- concerts. chronic and recurrent if untreated. 5 year follow up.
: fear of scrutiny by other people, individual avoids social situations. Onset is early in life.
: highly specific situations. Common in children and in adults they are chronic. treatment has a high success rate.
: sudden onset of severe anxiety with somatic and cognitive symptoms. Patients ko lagta hai ke heart attack hai ya death. A few minutes to hours. 90% overlap with agoraphobia.
Common in women, onset between 18-35.
: Not linked to any particular situation. Anxious cognitions.
women 2:1. Chronic
Biological: 30-40% role is genetic factors ka. GAD and depression share genetic predisposition. functional polymorphism in promoter region of serotonin transporter gene moderates effect of life events on depression.
: Bowlby's attachment theory. Bachpan ke traumatic events- high score on neuroticism.
are the factors that trigger the onset of a disease or illness.
: Life events. loss and separation etc.
childbirth, surgery. Social support is protective against these factors.
Management of anxiety disorders
: self help groups, education on symptoms etc.
or cognitive analytic therapy. BT for phobias.
: antidepressants, serotonin reuptake inhibitors, benzodiazepines etc. (detailed list on the slides).
: anxiety, depressive symptoms, causative factor. After an unpleasant life event. Aik mahinay baad. And should end after 6 months.