Spectrum of symtpoms:
GAD: excessive anxiety occurring more days than not for >6mo with 3+ of (felling on edge, fatigue, irritability, muscle tension, difficulty concentrating, sleep problems). Symptoms have significant overlap with depression. F:M = 2:1; highly comorbid with MDD (62); patients complaining of anxiety may have depression or comorbid depression.
8% (40% are exposed to trauma)
Comordbid with substance use and somatization d/o’s
Specific phobia: excessive persistent fear of a specific object or situation with avoidance and interference with functioning. In social phobia, “scrutiny by others” and the discovery of anxiety by others is most feared (more than fear of appearing incompetent, weak, etc). Social phobia has younger average age of onset – mid-teens. Social phobia is a primary specific phobia, must be distinguished from secondary social anxiety which may be a consequence of panic disorder. Beta-blockers is a good choice for performance anxiety. Pindolol is the only beta-blocker with serotonergic activity, less likely to contribute to depression. Panic disorder: >=4 of symptoms, most of which are somatic; high co-morbidity with somatization disorders. Prominent distinguishing factor is anticipatory anxiety, fear of having a somatic problem/panic attack again. There are also PTSD avoidance elements that characterize somatic sxs of panic disorder vs. somatoform disorder, where avoidance is generally absent. Agarophobia generally refers to fear of having a panic attack in a particular situation (not necessarily going outside); agarophobia may also occur without panic attack. Distinguish fear of a situation (specific phobia, external threat) vs. fear of having a panic attack (agoraphobia, internal threat), a...
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