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Neuroses and Stress-Related Disorders

0 In neuroses, the ability to evaluate reality is strong.

0 The main pathology in neuroses is often anxiety. (Free floating anxiety)

0 The division of psychiatric disorders into psychosis and neurosis is an old classification.

0 Diseases in the neurosis group in the old classifications: Anxiety disorders, obsessive compulsive disorder and related disorders, trauma and stress-related disorders, somatoform disorders, and dissociative disorders.

0 Neurosis is not defined in DSM IV TR and DSM S.

Anxiety Disorders

0 Obsessive-compulsive disorder and trauma-related disorders, which were classified as anxiety disorders in DSM IV TR, were excluded from this class in DSM S and examined in separate groups.

General Symptoms:

• tremor

• Back-headache

• Difficulty breathing

• Hyperventilation

• Autonomic hyperactivity (tachycardia, sweating, flushing, diarrhea, xerostomia)

• Difficulty in swallowing without organic disorder (globus hystericus)

Drugs Used in Treatment:

• SSRIs (they are the first drug of choice)

• Tricyclic antidepressants

• Other antidepressants (venlafaxine, mirtazapine, MAO inhibitors)

• Buspirone

• Benzodiazepines

• Propranolol

• Antiepileptics (valproic acid)


Panic Disorder

• It is characterized by spontaneous panic attacks.

• 50% of patients have mitral valve prolapse.

• Sodium lactate provokes attacks.

• Seizures usually come twice a week and last 30 minutes.

• Antidepressant drugs and psychotherapy are effective in treatment.

• Cognitive and systemic desensitization can be done.


Agoraphobia

• Fear of being in places where it might be difficult to get help or escape.

• There is a behavior of avoiding crowded places such as public transport, theatre, cinema, shops, open spaces or being alone outside.

• It is usually seen together with panic disorder.

• In this case, the patient is afraid of having a panic attack in the environment.


Specific Phobia

• It is the most common anxiety disorder.

• Characterized by irrational fear and avoidance of an object (dog) or situation (height).

• Anxiety happens when faced with the feared thing.

• Drug treatment is ineffective in specific phobias. The most effective treatment is systemic desensitization.


Social Anxiety Disorder (Social Phobia)

• It is characterized by irrational fear and avoidance of social situations.

• Antidepressant drug treatment can be applied together with psychotherapy.

• Propranolol can be used before social performances.

• MAO inhibitors have been found to be effective in severe cases.


Generalized Anxiety Disorder

• There is always a fear that something bad will happen.

• There is chronic generalized anxiety for at least one month.

• Drug treatment can be applied together with psychotherapy.

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