Anxiety disorder

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Post  counselor on Mon Oct 15, 2012 11:02 am

Anxiety disorder

The definition of disorders in. includes a set of symptom pictures that once fell in the great chapter of neurosis. At the base of the ailments is the anxiety symptoms, the expression of a state of suffering characterized by fear, insecurity, fear, sense of impending doom. According to the psychiatric tradition, the term neurosis indicated specific syndromes that Freud first gave a systematic classification. Analyzing the clinical and psychopathological, found, in fact, within the framework anxiety neurosis common elements such as acute episodes of anxiety, anxious expectation and phobias. In addition, at a later time, distinguished precise syndromic classes: the neurosis of a., Neurosis, phobic and obsessional neurosis. Among the most common classification systems, the DSM-IV-R (Diagnostic and Statistical Manual of Mental Disorders, ed. IV) abolished the term neurosis replacing it with the term general disorder. The tenth version of the International Classification of Diseases (ICD-10) in the header keeps the definition of neurotic disorders and stress-related and somatoform disorders, and individual diagnostic pictures are marked with the disturbance term. The abandonment of the term neurosis is, however, still the subject of heated debate: if the practicality of the new classificatory systems allows a predominantly pragmatic approach, there is less attention to understand the underlying mechanisms that cause the symptom, what was Instead, the peculiar trait of psychiatry and psychoanalysis. In DSM-IV-R dissociative disorders, somatoform disorders and adjustment disorders are distinguished by a. In the latter, ranged from panic disorder with and without agoraphobia, the disorder from to. generalized, agoraphobia without history of DAP, social phobia and specific disorder, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, a. due to medical conditions and that induced by substances. ICD-10 are treated in the same section of the anxiety disorders, stress and somatoform disorders, which are then divided into disorders a. phobic disorders in others., obsessive-compulsive disorder, reactions to severe stress and adjustment disorders, dissociative disorders (conversion), somatoform disorders, other neurotic disorders. Another element of differentiation between the two classifications is that in ICD-10, the simultaneous presence of a depressive episode prevents a diagnosis of panic disorder, while the DSM-IV-R not only eliminates the dichotomy between the two diagnostic disorders, but highlights their comorbidities, indicating greater severity from the point of view of the course and prognosis. In DSM-IV-R, there is a basic distinction between a. Acute (panic attacks) and a. chronic (a. generalized). Particularly evident then, has been attributed to interference from panic attacks, agoraphobia considering the secondary or closely linked to the DAP. In fact, the DSM-IV-R divides the DAP forms with and without agoraphobia, while the latter understood as the fear of being alone, of being in crowded places or public places where it is impossible to escape, takes a back seat; is not, however, highlighted the clinical variety of agoraphobia without panic attacks. ICD-10, on the contrary, agoraphobia is distinct in the forms with and without panic attacks, inserted in the group of disorders of a. phobic, thus putting in place the subject of symptoms of panic attacks. Also in this group, the ICD-10 emphasizes that the a. must be closely correlated with the condition phobic and should not be secondary to another psychopathology (such as delusions and obsessive thoughts). As well as the WHO classification, including that of the American Psychiatric Association (DSM-IV-R) describes two forms of phobia: the simple and social. In the first patient shows an irrational fear towards specific objects or situations, other than those specified for social phobia or agoraphobia, including animals, heights, blood, time and weather, darkness, etc.. The fear leads to an avoidance behavior that, in some cases, by severely interfere with the normal life of the subject. As far as social phobia, exposure to other people's judgment and fear of embarrassing to act against third parties induce the individual to be unable to speak in public, if you must write to tremble in the presence of others, not to able to speak in social situations etc.. It is a disorder that arises primarily in adolescence and can also lead to severe avoidance behaviors. Primary and secondary forms are distinguished: in the latter, the phobic disorder is associated with critical episodes (spontaneous panic attacks). This distinction is of considerable importance from a therapeutic point of view, since the forms are secondary benefit from the use of antidepressants that, on the contrary, are ineffective in primary forms. In addition, the use of beta-blockers in social phobia does not solve the concomitant presence of panic attacks. The disorder a. generalized (GAD or GAD: generalized anxiety disorder) is characterized, according to the DSM-IV-R, a. persisting for at least 6 months, a constant state of alarm, motor tension, autonomic hyperactivity and hypervigilance. Pathognomonic symptom of the disorder turns out to be waiting with anxious anticipation pessimistic. The classification of ICD-10 fits this disorder in the chapter Other anxiety disorders, excluding all those situations in which a. results in relation to specific environmental conditions. GAD is often found in combination with other mental disorders, making it difficult a precise diagnostic classification, in particular, often the diagnosis is based on exclusion of other medical conditions. Obsessive-compulsive disorder (OCD or OCD: obsessive-compulsive disorder) is currently included in the DSM-IV-R in the group of disorders a., But the clinical features of this disease make it possible to hypothesize, in the near future, a location independent. Another diagnostic category in the DSM-IV-R posttraumatic stress disorder includes (PTSD) and acute stress disorder. The stressful event in these forms plays an important etiologic role in the onset of the disease. Typical characteristics of PTSD are riesperimento the traumatic event, the persistent avoidance of stimuli associated with the trauma and the state of hypervigilance. Turns out to be substantial impairment of the normal social life of the subject. The acute stress disorder is characterized by transient disturbances (less than 1 month), which differentiate it from PTSD. In this type of disorders are often associated imposing anxiety manifestations also in somatic character. The ICD-10 also includes a further definition in the group Other anxiety disorders, namely the disturbance mixture of a. and depression, which places an emphasis on comorbid diseases. The two symptoms often occur simultaneously, making it difficult to isolate one form the other. It has been observed, in fact, as mood disorders, both in form and more, both in the minor ones, both in mixed episodes, often are associated with various paintings disorders a. Many studies have noted the frequent association, for example, between the disorders from panic attacks and major depression. The distinction between a. and depression can be difficult because some symptoms, such as sleep disorders, appetite, difficulty concentrating, irritability and fatigue, may be present in both diseases. It is also important to place a correct diagnosis even in anticipation of treatment since, for example, the exclusive use of benzodiazepines in the presence of depression can favor the persistence of depressive symptoms and may affect the course of the disease, favoring their chronicity. Required is therefore the adoption of therapeutic strategies that fit, from time to time, to individual cases.

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