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8/2/2019 Phobic and Other Anxiety Disorders 1
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PHOBIC AND OTHER ANXIETYDISORDERS
Presented By : Abdul Salam .K.P.Chaired by : Mr. Ravikesh Tripathi ,
Junior Consultant, Clinical Psychology
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Neurosis and Psychosis
Neurosis
Insight into illness
Distinguish between subjective experiences andreality
Reasonable social adjustment
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Psychosis
Lacks insight
Constructs a false environment out of
subjective experiences Whole personality being distorted
Hysteria with grossly abnormal personalitySchizophrenics still working
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Phobic Anxiety Disorders
Well defined situations
Palpitations & fear of dying/losing
control/going mad Anticipatory anxiety
Object external to the subject
Coexists with depression
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F40.0 Agoraphobia
Psychological or autonomic symptoms areprimary
At least two- crowds,public places,travellingaway from home,travelling alone
Avoidance of the situation F40.00 Without Panic Disorder
F40.001 with Panic Disorder (not a codable disorder in DSM)
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F40.1 Social Phobias
Fear of scrutiny by other people
Discrete fears
Fear of vomiting in the public Blushing, hand tremors,nausea,urgency of
micturition
May progress to panic attacks
Avoidance
If both social phobia and agoraphobia arepresent,precedence to be given to agoraphobia
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F40.2 Specific Phobias
Proximity to particular animals,heights,closedspaces,sight of blood
May evoke panic
Differentials:
Hypochondriacal disorder
Delusional disorder
Dysmorphophobia
DSM-
duration 6 month if
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F40.8 Other Phobic Anxiety
Disorders
F40.9 Phobic Anxiety Disorder,Unspecified
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F41 Other Anxiety Disorders
Panic disorder
Generalized Anxiety Disorder
Mixed Anxiety-Depressive Syndrome
Other Mixed Anxiety Disorders
Other Specific Anxiety Disorders
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F41.0 Panic disorder
Not restricted to any particular situation
Palpitations,chest pain,choking
sensations,depersonalisations andderealisations
Fear of dying/going mad
Avoidance due to fear of recurrence of attack
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Diagnostic guidelines
If a manifestation of phobia,it should be given the
precedence. Several attacks within around 1 month
In situations where there is no objective danger.
Unpredictable
No anxiety symptoms between attacks
DSM-
At least four symptoms
Anx. Should peak within 10 min.
Duration 1 month
Not due to sub. abuse or GMC
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F41.1 Generalized Anxiety
Disorder Free-floating anxiety
Must last for most days for several weeks
Apprehension Motor tension
Autonomic over activity
DSM-
6 months, at least 3 sympt. ,difficult to controlworry
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F41.2 Mixed Anxiety
Depressive Disorder Neither anxiety or depression is severe
Autonomic symptoms must be present
If associated with life events, adjustmentdisoredr should be made
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F41.3 Other Mixed Anxiety Disorders
GAD + Other Symptoms
F41.8 Other Specified Anxiety Disorders Like Anxiety Hysteria
F41.9 Anxiety Disorders, Unspecified