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Anxiety and OCD Disorders

Anxiety and OCD disorders

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Nuhamin Daniel
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27 views31 pages

Anxiety and OCD Disorders

Anxiety and OCD disorders

Uploaded by

Nuhamin Daniel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Anxiety and OCD disorders

• Introduction
• Anxiety disorders
• Obsessive compulsive disorders
Introduction
• Anxiety
 A diffuse, unpleasant, vague sense of apprehension, often
accompanied by autonomic symptoms such as headache, perspiration,
palpitations, tightness in the chest, mild stomach discomfort, and
restlessness, indicated by an inability to sit or stand still for long
 Anxiety is a response to a threat that is unknown, internal,
vague, or conflictual
 Emotional response to anticipated future threat
• Fear :
 Fear is a response to a known, external, definite, present or
nonconflictual threat
Epidemiology
• Anxiety disorders have annual and lifetime prevalence of 18%
and 28% respectively.
• Demographic factors
 Sex
 Early age of onset
 Childhood adverse events
 Comorbid with unipolar depression
• Significant impairment in the life of patients
Etiology
• Psychoanalytic theory
 Indicator of unconscious threat/affect/ that is going to be
conscious
 Leads to mobilization of defense mechanisms which limit
such dangers thoughts access to consciousness
 Symptoms are compromise formation of the above factors
• Cognitive and behavioral theories
 Anxiety sensitivity
 Overestimation of the threat and its consequence
 Underestimation of ones capacity to deal with it
 Specific cognitive distortions
 Classical conditioning
• Biological factors
 Noradrenergic system
 Excessive and hyperactive secretion of NE
 Dysfunctional presynaptic alpha2 receptors
 Hypothalamic pituitary adrenal axis (HPA)
 Increased level of cortisol and CRH
 Chronically hyperactive
 Mediated by childhood trauma
Fear processing circuits
Physical Symptoms of Anxiety?

• Physical
 Pounding heart  Tremors & twitches
 Sweating  Muscle tension
 Stomach upset  Headaches
 Dizziness  Fatigue
 Frequent  Insomnia
urination/diarrhea
 Shortness of breath
Affective Symptoms of Anxiety

• Emotional
 Apprehension or dread
 Trouble concentrating
 Tense & jumpy
 Anticipating the worst
 Irritability
 Restlessness
 Vigilance
 ‘blank mind’
Behavioral Symptoms of Anxiety

 Characterized by avoidances
 Noncompliance with medical procedure
Panic disorder
• Panic disorder is a common, distressing, and often disabling
condition in which patients experience recurrent unexpected
panic attacks
• Panic attacks
 Are periods of intense fear, apprehension, or discomfort that develop
suddenly and tend to reach a peak of intensity within 10 minutes of the
initiation of symptoms
 Experienced as unprovoked ,unexplained and out of the blue
• DSM V criteria require that at least 4 of 13 symptoms be present
to diagnose a panic attack
Panic Attack Symptoms
• Cardiac: palpitations, tachycardia, chest pain or discomfort
• Pulmonary: shortness of breath, a feeling of choking
• GI: nausea or abdominal distress
• Neurological: trembling and shaking, dizziness,
lightheadedness or faintness, paresthesias
• Psychological : depersonalization , derealization , fear of
dying and losing control
Cont.
• Anticipation and worry that there might be additional panic
attack
• Change in behavior so that to avoid the possibility of
additional panic attacks
Treatment
• Cognitive behavioral psychotherapy
• Psychodynamic therapy
• SSRIS
• Benzodiazepines
Social anxiety disorder
• Characterized by excessive anxiety in social situations where
one is exposed to possible scrutiny
• Fear of embarrassing one self and humiliating performance or
interpersonal interactions
• Avoidance these social situations
• Circumscribed or generalized
Cont.
• Etiological factors
 Onset during early adolescence
 Behavioral inhibition
 Modeling of parental social anxiety
 Social “traumatic“ experiences
Treatment
• Cognitive behavioral therapy
• SSRIS
I-Generalized Anxiety
Disorder
Generalized Anxiety Disorder

• An anxiety disorder characterized by disruptive levels of persistent,


unexplained feelings of apprehension and tenseness.
• GAD is not triggered by specific stimulus but instead is continuous
and generalized `` free floating``
• Life is a worry –past mistakes and future imagined catastrophes
occupy the mind constantly.
• See the life circumstance of the patient before the above diagnosis
Symptoms of Generalized Anxiety

• Must have at least three of the following:


 Restlessness
 Feeling on edge
 Difficulty concentrating/mind going blank
 Irritability
 Muscle Tension
 Sleep Disturbance
Treatment
• SSRIS
• CBT
Others
• Agoraphobia
• Specific phobia
• Selective muitism
• Separation anxiety disorder
Obsessive Compulsive Disorder

• Paradigmatic OCRD
• Constituted by either obsessive or compulsive
symptoms
• Obsession
 Intrusive and unwanted repetitive thoughts, urges, or
impulses that often lead to a marked increase in anxiety or
distress
• Compulsions
 Repeated behaviors or mental acts that are done in
response to obsessions, or in a rigid rule-bound way
 Aimed to reduce obsession related anxiety and distress
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Cont.
• Neuropsychiatric disorder
 Monozygotic twins concordance 80- 87%
 Abnormalities in cortico-striatal-thalamic-cortical (CSTC) circuitry
 Cognitive inflexibility and excessive habit formation
 Motor impulsivity
 Disgust sensitive
 Represents impaired control of automated, habitual behaviors

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• Typical Symptoms
 Contamination
 Pathologic doubt /checking/
 Intrusive/forbidden / thoughts
 Symmetry/ordering
 A lot of time spent on because of these
 Impact also significant to Family around patient

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Treatment
• Psychoeducation
• SSRIS
• Clomipramine
• CBT (Exposure and response prevention therapy)

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