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Adult Psychiatry SPMM Notes 2 – Questions/Solutions
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Adult Psychiatry SPMM Notes 2 – Questions/Solutions
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Adult Psychiatry SPMM Notes 2 – Questions/SolutionsAccording to the National Psychiatric Morbidity Survey in 1995, what was the
prevalence of anxiety in the UK? What did this survey suggest was the most
common anxiety disorder? Right Ans - 15%- suggesting that anxiety >
depression
Mixed anxiety depression, then GAD
What did the ECA and NCS suggest was the most prevalent anxiety disorder?
Right Ans - Phobias
What are the mean age of onset for specific phobias, social phobia, OCD, panic
disorder, GAD? What is the trend between generations? Right Ans - Specific
phobias= 5-9yrs
Social phobia= 15yrs
OCD= 20yrs
Panic disorder= 22-25yrs
GAD= 30yrs
At each generation, onset is earlier
What is the prevalence of blood-injection-injury phobia? What age? What is it
associated with? Right Ans - Prevalence = 3.5%
5-6yrs
Associated with fainting and seizures, women, lower education.
What is the general sex distribution of anxiety disorders? What are the
exceptions? Right Ans - Women>Men
Apart from OCD in children (but equalises when adult)
Men present with social phobia.
What is the point prevalence of OCD in adults and children? What is the
lifetime prevalence? Right Ans - Point prevalence= 1-2% of both adults and
children
, Lifetime prevalene- 2-3%
What is the gender ratio of OCD? Right Ans - In clinical samples M=F
but
F>M in community, suggesting males are more severe. Often earlier onset,
with tics and poorer outcomes.
What are the neurophysiological changes observed in OCD? Right Ans -
Hypermetabolism of caudate (basal ganglia)
D2 antagonists can cause secondary OCD like symptoms
What are OCD Spectrum Disorders? Right Ans - 1) Somatic e.g.
hypochondriasis, BDD, anorexia
2) Neurological/repetitive e.g. Tourettes, sydenhams chorea, ASD
3) Impulse control e.g. paraphilias, kleptomania, trichotillomania, pathological
gambling
What is PANDAS? What are the features? Right Ans - Paediatric
Autoimmune Neuropsychiatric Disorders Associated with Strep A infections
(Group A Beta Haemolytic)- OCD, tics, anxiety.
1) 3yrs--> adolescence
2) OCD or tic disorder
3) Sudden onset
4) Associated with GABHS
5) Abnormal neurological examination e.g. hyperactivity, choreiform
movements
Antistreptolysin O or AntiDNAseB titres raised post infection
Dose dependent OR of 3 if 1x episode <3 months, increases to 12 if 2x
What is the management of OCD? Right Ans - Mild/moderate = CBT +
Exposure and Response Prevention.
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