anxiety disorders diagnosis and treatment：焦虑症的诊断和治疗

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1、Anxietydisorders,Obsessive-CompulsiveandRelateddisorders,andTraumaandStressor-relatedDisordersHeidiCombs,MDAssistantProfessorUniversityofWashington/HMCPaulZarkowskiAssistantProfessorAFacultyDisclosureIhavenofinancialrelationshipstodiscloserelatingtothesubjectmatterofthispresenta

2、tionWhatwewillreviewEpidemiologyofanxietyandrelateddisordersComorbidpsychiatricdiagnosesDiagnosticcriteriaforanxietyandrelateddisordersNeuroimagingfindingsofanxietydisordersQuickquestionstoscreenforanxietydisordersTreatmentincludingpsychotherapyandpsychopharmacologyObjectivesLis

3、ttheprevalenceofanxietyandrelateddisordersIdentifycomorbidpsychiatricdiagnosesPerformaquickscreenforanxietyandrelateddisordersApplygeneralpharmacologicapproachestothetreatmentofanxietydisordersGeneralconsiderationsforanxietydisordersOftenhaveanearlyonset-teensorearlytwentiesShow

4、2:1femalepredominanceHaveawaxingandwaningcourseoverlifetimeSimilartomajordepressionandchronicdiseasessuchasdiabetesinfunctionalimpairmentanddecreasedqualityoflifeNormalversusPathologicAnxietyNormalanxietyisadaptive.Itisaninbornresponsetothreatortotheabsenceofpeopleorobjectsthats

5、ignifysafetycanresultincognitive(worry)andsomatic(racingheart,sweating,shaking,freezing,etc.)symptoms.Pathologicanxietyisanxietythatisexcessive,impairsfunction.FocusedNeuroanatomyReviewAmygdala-involvedwithprocessingofemotionallysalientstimuliMedialprefrontalcortex(includesthean

6、teriorcingulatecortex,thesubcallosalcortexandthemedialfrontalgyrus)-involvedinmodulationofaffectHippocampus-involvedinmemoryencodingandretrievalThedifferentialdiagnosisofanxiety.PsychiatricandMedicaldisorders.PsychiatrClinNorthAm1985Mar;8(1):3-23PrimaryversusSecondaryAnxietyAnxi

7、etymaybeduetooneoftheprimaryanxietydisordersORsecondarytosubstanceabuse(Substance-InducedAnxietyDisorder),amedicalcondition(AnxietyDisorderDuetoaGeneralMedicalCondition),anotherpsychiatriccondition,orpsychosocialstressors(AdjustmentDisorderwithAnxiety)AnxietydisordersSpecificpho

8、biaSocialanxietydisorder(SAD)Panicdisorder(PD)A