topic 3 - panic disorder

prognosis

100

What is the typical long-term course of panic disorder in terms of remission and relapse?

• Panic disorder often follows a chronic, relapsing-remitting course, with periods of symptom improvement and recurrence. (1 mark)
• Complete remission is possible, particularly with appropriate treatment, although some patients experience persistent symptoms or relapse. (1 mark)

200

Identify three factors associated with a poorer prognosis in patients with panic disorder.

1. Comorbid depression — associated with greater symptom severity and functional impairment.
2. Agoraphobia — avoidance behaviours reinforce anxiety and restrict daily functioning.
3. Substance misuse — can worsen anxiety symptoms and interfere with treatment effectiveness.

300

A patient receiving SSRI treatment experiences fewer panic attacks but continues to avoid crowded places. Why might their long-term functional prognosis remain impaired, and what treatment could improve it?

• Persistent anticipatory anxiety: Despite fewer panic attacks, the patient continues to fear future attacks. (1 mark)
• Avoidance behaviours: Avoiding crowded places reinforces anxiety and prevents complete functional recovery. (1 mark)
• Cognitive behavioural therapy (CBT) with graded exposure: Helps patients confront feared situations, reduce avoidance and improve long-term functioning. (1 mark)

historic / stigma

100

In which decade was the concept of panic disorder officially established, and in which edition of the DSM?

In the 1980s, specifically established in the DSM-III published in 1980.

200

List three examples of negative effects stigma surrounding panic disorders has on patients

• reduced hope

• lower self-esteem

• increased psychiatric symptoms

• difficulties with social relationships

• reduced likelihood of staying with treatment

• more difficulties at work

300

What kinds of stigma surround panic disorders?

• Panic disorder being treated as a personal weakness

• People with panic disorder being treated as dangerous 

pharm management

100

How long do SSRIs take to work

4-6 weeks

200

What are 5 common side effects of SSRIs

Nausea/GIT upset

Bowel changes

Dry mouth

Sweating 

agitation/shakes 

Weight and appetite changes

Sexual dysfunction 

Sleep disturbances

300

List 3 pharmacological management options for anxiety and briefly outline how they work

SSRI - block presynaptic serotonin transporter, preventing it’s absorption and increasing its extracellular concentration

Benzo - allosteric modulators of GABA channel resulting in downregulation of neuronal excitability

Beta blockers - block beta adrenergic receptors

Pregablin - GABA analogue that binds to subunit of voltage gated calcium channels to reduce calcium influx

non-pharm management

100

Breathing techniques help anxiety/panic disorders by activating what?

parasympathetic system

200

What is cognitive behavioural therapy? 

• Evidence based form of psychotherapy, and focuses on how thoughts/beliefs/interpretations influence feelings/anxiety

300

Maintaining a consistent schedule for what can regulate cortisol levels and improve emotional resilience? 

sleep

support services

100

Name 2 support services that provides 24/7 crisis support and suicide prevention services

1. Lifeline

2. Beyond Blue

200

Name 2 reasons a peer support group can help someone with a panic disorder

1. Feel less alone

2. Learn new coping mechanisms

3. Feel supported/motivated

4. Learn more about condition

300

Visiting a GP to create a Mental Health Treatment Plan allows you how many Medicare-subsidised sessions with mental health professional (e.g. psychologist)

10