Anxiety Disorders MCQs

In Agoraphobia, the individual fears or avoids specific situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms (e.g., fear of falling in elderly adults; fear of incontinence). The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. Reference : Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 9.3, Agoraphobia, Page 399.

Explanation: Agarophobia refers to the fear of being in crowded places Individuals with Agoraphobia often avoid situations where escape might be difficult. Duration: Symptoms last for ≥6 months. Key Symptoms: Fear/anxiety in specific situations (e.g., public transport, open spaces). Avoidance of situations due to fear of panic attacks. Fear and avoidance are disproportionate to potential threat. Exclusions: Not due to another medical or mental disorder.

The blood-injection-injury type is the most common type of phobia found (Option A) . It is differentiated from the others in that bradycardia and hypotension often follow the initial tachycardia that is common to all phobias (Option B) . The blood-injection-injury type of specific phobia is particularly likely to affect many members and generations of a family (Option C) . In the special situation of blood-injection-injury phobia, some therapists recommend that patients tense their bodies and remain seated during the exposure to help avoid the possibility of fainting from a vasovagal reaction to the phobic stimulation. Reference : Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 9.4, Specific Phobia, Page 402.

The DSM-5 includes distinctive types of specific phobia: Animal type (Option B) . Natural environment type(e.g., storms) (Option C) . Blood-injection injury type(e.g., needles) (Option A) . Situational type(e.g., cars, elevators, planes) Other type(for specific phobias that do not fit into the previous four types). Phobia for social situations is termed as Social phobia , which is separate entity from Specific Phobia Reference : Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 9.4, Specific Phobia, Page 402.

Wandering behavior is seen during a variety of conditions like dissociative fugue , substance intoxication, delirium, dementia, manic phase of bipolar disorder, schizophrenia. (Option A, C & D) It is less likely during panic attack. Reference: Kaplan and Sadock's Synopsis of Psychiatry, 11th edition, Chapter 12, Dissociative disorders, Page number 457.

Buspirone is an anxiolytic medication with 5-hydroxytryptamine(5-HT1A) partial agonist activity. It is a potent D2-receptor antagonist (OPTION B IS CORRECT) . It is mainly used for treatment of generalised anxiety disorder and other anxiety disorders. Even though it is an antianxiety medication, it is not related to benzodiazepines or barbiturates. It is not helpful for treating benzodiazepine withdrawal symptoms. These patients will need benzodiazepines to relieve their symptoms before starting buspirone. Reference: Synopsis of Psychiatry, Eleventh edition, Chapter 29th, Page no. 957.

The FDA recently placed a black box warning for the use of antidepressants in children and adolescents. This warning reminds clinicians of some evidence indicating a possible increased incidence of suicidal thoughts among adolescents using antidepressants-particularly SSRIs. Reference : Kaplan and Sadock's Synopsis of Psychiatry, Eleventh edition, Chapter 31.13, Anxiety Disorders of Infancy, Childhood and Adolescence, Page no. 1254.

Agoraphobia is anxiety associated with places or situations either from which escape may be difficult or in which help may not be available in the event of a panic attack. It means literally fear of the crowded place . It is strongly associated with panic. ( OPTION B ) Reference: Synopsis of Psychiatry, eleventh edition, chapter 9, page no. 395