Anxiety Neurosis Study Notes

‭Anxiety neurosis‬ ‭Anxiety neurosis corresponds to what American authors now call panic attacks.‬ ‭ pidemiology‬‭–The lifetime risk of developing anxiety neurosis is 1 to 3%. Manifestations‬‭most‬ E ‭often appear in late adolescence or early adulthood. There is a significant link with agoraphobia.‬ ‭ emonstrations‬‭–The first attack typically occurs when the subject is away from home. In its‬ D ‭acute form, it combines:‬ -‭ ‬ ‭-‬ ‭-‬ ‭-‬ ‭-‬ ‭-‬ ‭-‬ t‭remors;‬ ‭dyspnea;‬ ‭chest pain and palpitations;‬ ‭sweats;‬ ‭nausea, abdominal pain;‬ ‭dizziness;‬ ‭fear of dying or going crazy.‬ ‭There is also a chronic form marked by a permanent background of anxiety.‬ ‭ tiology‬‭–It is unknown but at least two observations deserve mention. First, the concordance‬ E ‭between monozygotic twins reaches 30 to 45%. Secondly, it seems that this pathology is‬ ‭accompanied by a massive noradrenergic discharge in the locus coeruleus (small nucleus located‬ ‭in the brainstem).‬ ‭phobic neurosis‬ ‭Phobic neurosis was individualized by the famous Sigmund Freud under the name anxiety hysteria.‬ ‭ pidemiology‬‭–The lifetime risk of developing phobic neurosis is 10%.‬ E ‭Manifestations appear most often in early adulthood.‬ ‭Demonstrations‬‭–The‬ ‭phobia‬ ‭can‬ ‭be‬ ‭linked‬ ‭to‬ ‭objects‬ ‭(arachnophobia)‬ ‭or‬ ‭to‬ ‭situations‬ ‭(agoraphobia, ereutophobia). The patient can then develop two types of responses:‬ ‭-‬ ‭or‬ ‭avoidance‬ ‭behaviors,‬ ‭in‬ ‭order‬ ‭not‬ ‭to‬ ‭find‬ ‭themselves‬ ‭confronted‬ ‭with‬ ‭the‬ ‭phobic‬ ‭stimulus‬ ‭(example:‬ ‭a‬ ‭superstitious‬ ‭subject‬ ‭makes‬ ‭a‬ ‭detour‬ ‭so‬ ‭as‬ ‭not‬‭to‬‭pass‬‭through‬‭a‬ s‭ treet in which he knows that there are black cats;‬ ‭-‬ ‭or counterphobic behavior, voluntary confrontation with the phobic stimulus with the aim of‬ ‭“desensitization” (example: a subject suffering from vertigo will decide to go mountain climbing).‬ ‭Etiology‬‭–It is unknown but some studies reveal that the concordance between monozygotic‬ ‭twins reaches 23% (15% in the case of dizygotic twins). Chromosome 14 is sometimes‬ ‭suspected.‬ ‭Obsessive neurosis‬ ‭Obsessive neurosis was called reasoning madness by Philippe Pinel.‬ ‭ pidemiology‬‭–The‬ ‭lifetime‬ ‭risk‬ ‭of‬ ‭developing‬ ‭obsessive‬ ‭neurosis‬ ‭is‬ ‭2‬ ‭to‬ ‭3%.‬ ‭Manifestations‬ E ‭appear‬ ‭most‬ ‭often‬ ‭at‬ ‭the‬ ‭beginning‬ ‭of‬ ‭adulthood,‬ ‭mainly‬‭in‬‭men,‬‭especially‬‭if‬‭they‬‭are‬‭the‬‭first‬ ‭born‬ ‭in‬ ‭the‬ ‭family.‬ ‭There‬ ‭is‬ ‭a‬ ‭statistically‬ ‭significant‬ ‭association‬ ‭with‬ ‭Gilles‬ ‭de‬ ‭la‬ ‭Tourette‬ ‭syndrome.‬ ‭Demonstrations‬‭–Obsessive neurosis classically combines obsessions and compulsions:‬ ‭-‬ ‭Obsessions impose themselves on the patient without him being able to exercise any control‬ ‭over them. They can be ideational (“did I close the door properly before leaving?”), phobic‬ ‭(phobia of dirt or germs in the absence of the phobic stimulus), or impulsive (fear of‬ t‭hrowing oneself under a train);‬ ‭-‬ ‭compulsions (or conjuring rituals) are mental acts or iterative behaviors to which the subject feels‬ ‭compelled in order to reduce anxiety (in the three examples in the previous paragraph, these‬ ‭would be the following compulsions: 1) the subject returns several times to check whether‬ ‭he has closed his door properly, 2) the subject washes his hands dozens, even hundreds of‬ ‭times a day, and throws away the used soap to take a new one each time, 3) the subject‬ ‭eliminates all proximity to a railway line). The accumulated compulsions last more than an‬ ‭hour a day.‬ ‭Etiology‬‭–She is unknown. Chromosome 2 is sometimes suspected.‬