Anxiety, phobias and OCD

Specialties > General practice

Differential Diagnosis Schema 🧠

Anxiety Disorders

Generalized Anxiety Disorder (GAD): Excessive, uncontrollable worry about various aspects of daily life, lasting at least 6 months.
Panic Disorder: Recurrent unexpected panic attacks, along with worry about future attacks or their consequences.
Social Anxiety Disorder (Social Phobia): Marked fear of social situations where one might be scrutinized by others, leading to avoidance.
Agoraphobia: Anxiety about being in situations where escape might be difficult or help unavailable if panic-like symptoms occur.

Phobias

Specific Phobias: Intense, irrational fear of a specific object or situation, leading to avoidance behavior.
Social Phobia: Overlapping with Social Anxiety Disorder, marked fear of social situations.
Agoraphobia: Often associated with panic disorder, fear of being in situations where escape is difficult.

Obsessive-Compulsive Disorder (OCD)

Obsessions: Recurrent, persistent, and intrusive thoughts, urges, or images causing marked anxiety.
Compulsions: Repetitive behaviors or mental acts performed in response to an obsession, aimed at reducing distress or preventing a feared event.

Other Mental Health Disorders

Depression: Persistent low mood, anhedonia, and feelings of worthlessness or guilt, which can co-exist with anxiety.
Post-Traumatic Stress Disorder (PTSD): Anxiety symptoms following exposure to a traumatic event, including flashbacks and avoidance.
Acute Stress Disorder: Similar to PTSD, but occurs within 1 month of the traumatic event.
Adjustment Disorder: Emotional or behavioral symptoms in response to a stressor, not meeting criteria for another disorder.

Medical Conditions

Hyperthyroidism: Symptoms can include anxiety, tremors, palpitations, and weight loss.
Cardiac Arrhythmias: Palpitations and a sense of impending doom can mimic anxiety.
Asthma: Can lead to hyperventilation, which may be misinterpreted as anxiety.
Pheochromocytoma: A rare tumor that can cause paroxysmal episodes of anxiety-like symptoms.

Key Points in History 🥼

Symptoms

Onset: Sudden onset may suggest a panic attack or acute stress disorder, while gradual onset may be more consistent with GAD or OCD.
Duration: Persistent symptoms over 6 months are necessary for GAD diagnosis.
Triggers: Specific triggers may point towards phobias or PTSD, while non-specific triggers could suggest GAD.
Associated Physical Symptoms: Such as palpitations, sweating, or dizziness, common in anxiety disorders.
Avoidance Behavior: Common in phobias and OCD, where the patient avoids triggers of anxiety.
Repetitive Behaviors: Suggestive of OCD if the patient engages in ritualistic actions to alleviate distress.
Sleep Disturbance: Often reported in GAD and PTSD.
Impact on Daily Life: Assess the degree to which anxiety or compulsive behaviors interfere with normal functioning.

Background

Past Medical History: Look for a history of psychiatric disorders, thyroid disease, or other relevant medical conditions.
Drug History: Assess for use of stimulants (e.g., caffeine, amphetamines), corticosteroids, or withdrawal from substances, all of which can exacerbate anxiety.
Family History: A positive family history of anxiety, depression, or OCD can increase the likelihood of these disorders.
Social History: Consider recent life stressors, alcohol or drug use, and social support systems, which can all impact anxiety levels.
Childhood History: Early life stress or trauma can predispose to anxiety disorders and PTSD.

Possible Investigations 🌡️

Blood Tests

Full Blood Count (FBC): To rule out anemia or infection that could exacerbate anxiety.
Thyroid Function Tests: To exclude hyperthyroidism.
Electrolytes: To identify imbalances that could contribute to symptoms.
Blood Glucose: To rule out hypoglycemia.
Toxicology Screen: If substance use is suspected.

Imaging

ECG: To rule out cardiac causes for palpitations and chest pain.
MRI/CT Brain: Consider if neurological symptoms are present, or to exclude organic causes of anxiety.

Psychiatric Assessment

Screening Tools: Use validated tools such as GAD-7 for generalized anxiety, PHQ-9 for depression, or the Yale-Brown Obsessive Compulsive Scale for OCD.
Mental State Examination (MSE): Assess the patient’s appearance, behavior, mood, thoughts, perceptions, cognition, and insight.

No comments yet 😉

Leave a Reply Cancel reply

You must be logged in to post a comment.

Don't take our word for it

"The stations you provide are strikingly similar to those I came across during my medical school finals (some even verbatim!), and I have tried many other exam platforms. I'm truly grateful for your priceless support throughout my final couple of years at medical school!"

Raza Q 🇬🇧

"It has absolutely everything for medical school, so many histories with detailed differential diagnoses, how to approach emergencies, commonly prescribed drugs..every kind go examination you’ll ever need in osces"

John R 🇬🇧

"Thank you SO MUCH for the amazing educational resource. I’ve tried lots of platforms and books with mock OSCE stations and yours is by far and away the best I’ve tried"

Ed M 🇳🇿

"Get this right away. So helpful for OSCEs but also general clinical learning and understanding. Wish I had brought it sooner"

Emma W 🇬🇧

"Without a doubt, your platform outshines all other OSCE resources currently available. In all honesty, I can confidently attribute my success in securing a distinction in my finals to OSCEstop."

Harish K 🇬🇧

"OSCEstop distinguishes itself from many other platform banks by offering a wealth of questions that mimic the demanding and complex aspects of our finals. This platform played a crucial role in ensuring I was ready for the level of difficulty that awaited me in my final exams."

Natasha W 🇳🇿

😃 More:

📖 Learning notes: 247

🏥 Stations available: 207

🧠 Qbank questions: 2255