Vanin / Helsley Anxiety Disorders

A Pocket Guide For Primary Care
1. Auflage 2008
ISBN: 978-1-59745-263-2
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 266 Seiten

Reihe: Current Clinical Practice

This pocket guide is designed to help the primary care practitioner recognize, diagnose, and manage anxiety disorders in a busy clinical practice. It presents an easy-to-follow, step-by-step approach, and offers practical points based on both real patient-care experience and review of current medical literature. The guide includes helpful chapters on psychopharmacology, psychopharmacotherapy, and psychologic treatment for the anxiety disorders.

Autoren/Hrsg.

Vanin, John

Helsley, James

Inhaltsverzeichnis

1;Series Editor’s Introduction;6
2;Foreword;8
3;Preface;10
4;Acknowledgments;14
5;Table of Contents;16
6;Contributors;18
7;Overview of Anxiety and the Anxiety Disorders;19
7.1;Anxiety Disorders;21
7.2;Biopsychosocial Factors;24
7.3;Understanding Fear And Anxiety;25
7.4;Anxiety: Neurons And Neurochemistry;27
7.5;How A Neuron Works;28
7.6;Serotonin System;28
7.7;Norepinephrine (Noradrenergic) System;28
7.8;gama-Aminobutyric Acid;29
7.9;Treatment Of Anxiety Disorders;29
7.9.1;History of Treatment;29
7.9.2;Primary Care Assessment;29
7.9.3;Treatment Modalities;30
7.9.3.1;Psychotherapy;31
7.9.3.2;Pharmacotherapy;31
7.9.3.3;Education;32
7.9.3.4;Principles of Psychopharmacotherapy;32
7.9.3.5;When to Seek Assistance from a Mental Health Professional;33
7.10;References;35
8;Brief Psychiatric History and Mental Status Examination;37
8.1;Evaluating Anxiety Disorders;37
8.2;Diagnosis of Anxiety Disorders;38
8.3;Screening for Anxiety Disorders;41
8.4;Anxiety Disorders and General Medical Disorders;44
8.5;Brief Psychiatric Evaluation;45
8.6;Psychiatric History;47
8.7;Anxiety Disorder Screening Instruments;48
8.8;Primary Care Psychiatric Evaluation Guideline (PCPEG);51
8.8.1;Chief Complaint/Reason for Evaluation;51
8.8.2;History of Present Illness;51
8.8.3;Past History;51
8.8.4;Current Medications;52
8.8.5;Allergies;52
8.8.6;Substance Use;52
8.8.7;Personal/Social History;52
8.8.8;Family History;52
8.8.9;Review of Systems;52
8.8.10;Physical Examination;52
8.8.11;Mental Status Examination;53
8.8.12;Functional Assessment/Differential Diagnosis;53
8.8.13;Treatment Plan;53
8.9;References;54
9;Psychopharmacology;57
9.1;Neurotransmitters;58
9.2;Receptors;59
9.3;Serotonergic System;59
9.4;Serotonin Receptors;60
9.5;Noradrenergic System;61
9.6;Dopaminergic System;61
9.7;Cholinergic System;62
9.8;Gabaergic System;63
9.9;Glutamatergic System;63
9.10;Neuropeptides;64
9.11;Pharmacokinetics and Pharmacodynamics;65
9.12;Pharmacokinetics;66
9.12.1;Absorption;67
9.12.2;Distribution;73
9.12.3;Metabolism;74
9.12.4;Elimination;74
9.13;Multiple Dosing and Steady State;75
9.14;Pharmacodynamics;76
9.15;Tolerance;77
9.16;Dose-Effect Relationship Variability;77
9.17;Summary;79
9.18;References;79
10;Psychopharmacotherapy;81
10.1;History of Anxiolytics;81
10.2;Treatment;83
10.3;Pharmacotherapy;84
10.3.1;Antidepressants;84
10.3.1.1;Selective Serotonin Reuptake Inhibitors;84
10.3.1.1.1;Pregnancy and Lactation;96
10.3.1.2;Serotonin-Norepinephrine Reuptake Inhibitors;99
10.3.1.3;Benzodiazepines;102
10.3.1.3.1;Clinical Characteristics;104
10.3.1.3.2;Mechanism of Action;105
10.3.1.3.3;Pharmacokinetics;106
10.3.1.3.4;Adverse Effects;107
10.3.1.3.5;Drug Interactions;107
10.3.1.3.6;Tolerance;108
10.3.1.3.7;Physical Dependence, Discontinuation, and Abuse;108
10.3.1.3.8;Pregnancy;110
10.3.1.4;Azapirones: Buspirone;113
10.3.1.4.1;Action;114
10.3.1.4.2;Pharmacokinetics;114
10.3.1.4.3;Clinical Use;115
10.3.1.4.4;Adverse Effects;115
10.3.1.5;Tricyclic Antidepressants;116
10.3.1.5.1;Pharmacokinetics;117
10.3.1.5.2;Clinical Use;118
10.3.1.5.3;Adverse Effects and Risks;118
10.3.1.5.4;Metabolism and Drug Interactions;120
10.3.1.5.5;Pregnancy and Lactation;121
10.3.1.6;Monoamine Oxidase Inhibitors;121
10.3.1.6.1;Use in Anxiety Disorders;122
10.3.1.6.2;Side Effects and Interactions;122
10.3.1.7;Hydroxyzine;123
10.3.1.7.1;Adverse Effects;124
10.3.1.8;Other Medications for Common Anxiety Disorders;124
10.3.1.8.1;Generalized Anxiety Disorder;124
10.3.1.8.2;Social Anxiety Disorder;125
10.3.1.8.3;Panic Disorder;125
10.3.1.8.4;Obsessive-Compulsive Disorder;125
10.3.1.8.5;Posttraumatic Stress Disorder;125
10.4;Summary;126
10.5;References;126
11;Psychotherapy;131
11.1;Psychotherapeutic Approaches;132
11.1.1;Insight-Oriented Psychotherapy;132
11.1.2;Person-Centered Psychotherapy;132
11.1.3;Behavior Therapy;133
11.1.4;Cognitive Therapy;133
11.2;Efficacy and Effectiveness of Psychotherapy in Treating Anxiety Disorders;133
11.3;Cognitive Behavior Therapy Approach for Treating Anxiety Disorders;138
11.3.1;Evaluation and Education;138
11.3.2;Skills Acquisition;139
11.3.3;Exposure Therapy;140
11.4;Collaboration Between Primary Care practitioners And Psychotherapists;141
11.4.1;Making the Referral;142
11.4.2;Medication Management;142
11.4.3;Monitoring Progress in Psychotherapy;143
11.5;Summary;145
11.6;References;146
12;Adjustment Disorder with Anxiety;147
12.1;Associated Features;148
12.2;Epidemiology;149
12.3;Course and Prognosis;149
12.4;Etiology;149
12.5;Differential Diagnosis;150
12.6;Treatment;150
12.7;Summary;152
12.8;References;152
13;Panic Disorder;153
13.1;Definition;153
13.2;Incidence and Prevalence;153
13.3;Further History: Important Areas to Consider During the Workup;155
13.4;Diagnosis;155
13.5;Agoraphobia;156
13.6;Etiology Theories;156
13.7;Neurobiology;157
13.8;Treatment;157
13.9;Medication;158
13.9.1;Benzodiazepines;158
13.9.2;Selective Serotonin Reuptake Inhibitors;158
13.9.3;Other Medication Treatments;159
13.10;Further Drug Considerations;159
13.11;General Considerations of Treatment;161
13.11.1;Benzodiazepine Abuse Potential;161
13.11.2;Comorbidity;161
13.11.3;Treatment Compliance;162
13.12;Cognitive Behavior Therapy;162
13.13;Summary;164
13.14;References;164
14;Specific Phobia;167
14.1;Associated Features;169
14.2;Epidemiology;169
14.3;Onset;169
14.4;Etiology;170
14.5;Treatment;172
14.5.1;Therapy;172
14.5.2;Pharmacotherapy;173
14.6;Summary;174
14.7;References;174
15;Social Phobia (Social Anxiety Disorder);177
15.1;Definition;177
15.2;Diagnosis;177
15.3;Avoidant Personality Disorder;179
15.4;Treatment;179
15.4.1;Psychotherapy;179
15.4.2;Pharmacological Treatment;179
15.4.2.1;SSRIs/SNRIs;179
15.4.2.2;Benzodiazepines;180
15.4.3;Other Pharmacological Therapy;181
15.4.3.1;Beta-Blockers;181
15.4.3.2;Buspirone;181
15.4.3.3;Atypical Antipsychotics;182
15.4.3.4;Tricyclic Antidepressants;182
15.4.3.5;Monoamine Oxidase Inhibitors;182
15.5;References;184
16;Obsessive-Compulsive Disorder;185
16.1;Definition;185
16.2;Diagnosis;186
16.3;Obsessive-Compulsive Personality Disorder;187
16.4;Treatment;188
16.4.1;Cognitive Behavior Therapy;188
16.4.2;Medical Therapy;188
16.4.2.1;Benzodiazepines;188
16.4.3;Newer Therapeutic Approaches;189
16.5;References;191
17;Posttraumatic Stress Disorder;193
17.1;Definition;193
17.2;Comorbidity;193
17.3;Neurobiology;195
17.4;Acute Stress Disorder;195
17.5;Treatment;196
17.5.1;Psychopharmacology;196
17.5.2;Psychotherapeutic Interventions;197
17.5.3;Psychoeducation and Support;197
17.6;References;198
18;Generalized Anxiety Disorder;201
18.1;Definition;201
18.2;Etiology;202
18.3;Evaluation;203
18.3.1;Rating Scales;203
18.3.2;Medical Disorders;203
18.3.3;Substance Abuse;204
18.3.4;Comorbidity;204
18.4;Treatment;204
18.4.1;Cognitive Behavior Therapy;204
18.4.2;Pharmacotherapy;205
18.4.2.1;Benzodiazepines;205
18.4.2.2;Selective Serotonin Reuptake Inhibitors;205
18.4.2.3;Buspirone;207
18.4.2.4;Serotonin-Norepinephrine Reuptake Inhibitors;207
18.4.2.5;Tricyclic Antidepressants;207
18.4.2.6;Monoamine Oxidase Inhibitors;208
18.4.2.7;Other Treatments;208
18.5;References;210
19;Anxiety Disorder Due to a General Medical Condition;213
19.1;Definition;214
19.2;Common Medical Conditions Associated With Anxiety;214
19.2.1;Chronic Obstructive Pulmonary Disease;214
19.2.2;Asthma;215
19.2.3;Medication-Related Anxiety in Chronic Obstructive Pulmonary Disease/Asthma;216
19.2.4;Heart Disease;216
19.2.5;Hyperthyroidism;219
19.2.6;Dietary Intake;219
19.2.7;Cancer;220
19.2.8;Irritable Bowel Syndrome;221
19.3;References;224
20;Anxiety Disorders and Comorbidities;227
20.1;History;227
20.2;Anxiety Disorders With Comorbid Depression;228
20.3;Risk Factors For Anxiety Disorders and Depression;229
20.4;Treatment of Anxiety Disorders and Depression;230
20.5;Treatment of Anxiety Disorders with Comorbid Depression;231
20.6;Anxiety Disorders and Comorbid Bipolar Disorder;232
20.7;Mood Stabilization;233
20.8;Anxiety Disorders and Comorbid Adult Attention-Deficit Hyperactivity Disorder;233
20.9;Anxiety Disorders and Comorbid Personality Disorders;234
20.10;Definitions of Each Personality Disorder as Listed In The DSM-IV-TR;235
20.11;Anxiety Disorders and Comorbid substance Abuse;236
20.12;References;237
21;Geriatric Anxiety and Anxiety Disorders;239
21.1;Pharmacokinetics and Aging;240
21.2;Differential Diagnoses in Geriatric Anxiety;243
21.2.1;Depression in the Elderly;243
21.2.2;Dementia;244
21.2.3;Delirium;246
21.3;Treatment;247
21.3.1;Medication Compliance;247
21.3.2;Medical Therapy;248
21.3.2.1;Benzodiazepines;248
21.3.2.2;Selective Serotonin Reuptake Inhibitors;248
21.3.2.3;Tricyclic Antidepressants;252
21.3.2.4;Other Medication Treatment Options;252
21.3.2.5;Cognitive Behavior Therapy;254
21.4;References;259
22;Anxiety Disorders Resources;261
23;Glossary;265
24;Index;277