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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