Anxiety : is response to a threat that is unknown , internal , vague or conflictual in origin , chronicity

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• ? ? ? ? ? ? ? ? ?
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??? ? ? ? ?

• Anxiety is response to a threat that is
  unknown , internal , vague
  or conflictual in origin , chronicity
• Fear is response to a threat that is known ,
  external , definite , or nonflictual in origin ,
  acuteness

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• ????????????
• ????????
• 1.????????
• 2.????????????????? ???????
• 3.???????????(?????)
• 4.????????????????

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Anxiety disorder overview?Freuds anxiety
neurosis 2 forms of anxiety

• 1. from dammed-up libido
• neurasthenia, hypochondriasis, anxiety
  neuroses
• 2. a diffuse sense of worry or dread that
  originates in a repressed thought or
  wishpsychoneuroses
• hysteria, phobias, obsessional neuroses

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Psychological theories

• 1.psychoanalytic theories
• 2.behavior theories
• 3.existential theories
• Biological theories
• 1.ANSadrenal release of epinephrine --gt
• CNS anxiety procedes --gt increased
• sympathetic tone
• 2.neurotransmitters NE, serotonin, GABA
• 3.brain imaging and neuroanatomical studies

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?????? 1.????
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(No Transcript)
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2.?????(1)Panic attack---

• ?????????????????,???????????(?????),?????????????
  
• lt1gt?????????????
• lt2gt??
• lt3gt?????(trembling or shking)
• lt4gt??????????

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lt5gt??? lt6gt?????

• lt7gt????????
• lt8gt???????????????
• lt9gt?????(???????)?????
• ?(???????)
• lt10gt????????????
• lt11gt??????
• lt12gt????(paresthesias)(???????)
• lt13gt??????(chills or hot flushes)

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(2)Agoraphobia(3)Panic disorder without
agoraphobia

• (4)Panic disorder with agoraphobia
• (5)Specific phobia
• (6)Social phobia

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(7)Obsessive compulsive disorder

• ?????????????
• ???????? ---
• lt1gt???????????????,???? ?? ?????????(intrusive
  ),????,????????????
• lt2gt????????????????????????????
• lt3gt???????????????????,??????????????????(neutrali
  ze)
• lt4gt???????????????????????????(??????????????)

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??????? ---

• lt1gt?????(?????????)?????(?????????????),??????????
  ?????????????????????????
• lt2gt??????????????????????????????????????????????
  ??????????,????????????,???????????

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(8)Posttraumatic Stress disorder???,??,????--??
????????--????????---???????,???????,?????---for
one month (9)Acute Stress disorder 2 days to 4
weeks

• (10)Generalized anxiety disorder
• A.?????????(?????????)???????(?????),?????????????
  ???????
• B.?????????????

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.

• C.??????????????????(?????) ???????????
  (????????,?????????????????)
• lt1gt?????????????(on edge)
• lt2gt????
• lt3)gt???????????
• lt4gt??
• lt5gt????(muscle tension)
• lt6gt????(?????????,????????????)

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(11)Anxiety disorder due to a general
medical condition(12)Substance-induced anxiety
disorder(13)Anxiety disorder not otherwise
specified
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3.???????????(Adjustment disorder with anxiety
or depressive mood)

• A.????????????(identifiable stressor)?????,???????
  ???????????????
• B. ??????????????,?????? ????
• (1)?????,????????????????
• (2)?????(????)???????

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a.????(????????? ???????)
b.????(????????? ??)c.??????????(??? ???)

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• 4.??????
• (Major depressive episode)
• ???????,??????????(?????),???????????(1)?????(2)?
  ???????????????????
• lt1gt????,??????,??????,???? ??(????????)??????(???
  ????)???
• ????????????????

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• lt2gt???????????,??????????,
• ??????,??????(?????????
• ??????)
• lt3gt????????????,?????(????
• ????????5)????????????? ?????,????????????
  ???
• lt4gt?????????
• lt5gt??????????????(????????,
• ????????????????)

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• lt6gt???????????
• lt7gt?????????,???????????(??????)(??????????????)
• lt8gt?????????????????????(indecisiveness)?(????????
  ???????)
• lt9gt??????(???????????)???? ???????????????????????
  ????????

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5.?????

• (1)?????????????????? ??? ???????
• (2)???????---??????????????????????????
• (3)?????????????---???????????????????????????????
  ??

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????

• 1.????
• (a)???? TCA, MAOI, SSRI
• (b)???? xanax(alprazolam)
• 2.??????????
• 3.?????????????
• 4.??????

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?????????

• 1.??????????????????????????
• 2.????
• 3.????
• 4.????
• 5.????
• 6.????
• 7.?????????

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• (a) Phobia---?????----??????????(?????????)
• (b) Obsessive compulsive disorder---???????????---
  ?????????????
• 1.?? ???????
• 2.????????
• (c) Social phobia????????????????????

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• (d) ?????????
• 1.???????????? ???????????
• 2.???????????????????????????
• (e) ?????????----???
• ??????????

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??????????????????????????????????????????---??
???

• 1.????
• 2.???
• 3.??????????
• 4.????????
• 5.????
• 6.????????????

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??????Part 1

• 1.???? ????
• 2.???? ????
• 3.???? ????
• 4.???? ????
• 5.???? ????
• 6.???? ????
• 7.???? ????
• 8.???? ????
• 9.???? ????
• 10.???? ????
• 11.???? ????
• 12.???? ????

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??????Part 2

• ???? ???? ???? ???? ????
• ??????
• ????????? ?????????

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Chien-Chih Chen, Tiao-Lai Huang Association
between serum lipid profiles and depressive or
anxious states in menopausal women (submit) Tiao
L. Huang, Chun Y. Lu Serum lipid profiles and
treatment responses in patients with major
depressive disorder causes or consequences?
(submit) Tiao-Lai Huang , Hsieh-Shong Leu ,
Jien-Wei Liu Lymphocyte subsets and viral load
in drug-naïve AIDS patients with major
depression a naturalistic study
(submit) 1.Tiao-Lai Huang, Jung-Fu Chen Weight
changes, treatment responses and the correlations
to lipid changes in schizophrenic patients after
antipsychotics therapy. Progress in
Neuro-Psychopharmacology and Biological
Psychiatry 2005 (SCI, revised) 2.Tiao-Lai Huang,
Chien-Te Lee Associations between serum
brain-derived neurotrophic factor levels and
clinical phenotypes in schizophrenia patients.
Journal of Psychiatry Research 2005 (accepted,
SCI) 3.Yi-Yung Hung, Ping-Suen Yang, Tiao-Lai
Huang Clozapine in schizophrenia patients with
recurrent catatonia report of two cases.
Psychiatry and Clinical Neurosciences 2005
(accepted, SCI) 4.Tiao-Lai Huang, Chien-Te Lee
Low serum albumin and high ferritin levels in
chronic hemodialysis patients with major
depression. Psychiatric Research 2005 (accepted,
SCI) 5.Tiao-Lai Huang, Jung-Fu Chen Serum lipid
profiles and schizophrenia effects of
conventional or atypical antipsychotic drugs in
Taiwanese. Schizophrenia Research 2005, 80
55-59. (SCI) 6.Tiao-Lai Huang, Jung-Fu Chen
Cholesterol and lipids in depression stress,
hypothalamo-pituitary-adrenocortical axis and
inflammation/immunity. Advances in Clinical
Chemistry 2005, 39 81-105.(review medical
laboratory technology SCI) 7.Tiao-Lai Huang
Serum lipid profiles in major depression with
clinical subtypes, suicide attempts and episodes.
Journal of affective disorders 2005 86(1)75-79.
(SCI) 8. Tiao-Lai Huang Lorazepam and diazepam
rapidly relieve catatonic signs in patients with
schizophrenia. Psychiatry and Clinical
Neurosciences 200559(1)52-55. (SCI)
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SARS?? V.S 921 ??

• What is SARS knowledge
• --unknown or poverty(????,????)
• --learning new scientific data(????)
• What is the threat(??) of SARS for you, your
  family, ??,??
• ---??? SARS?????? ????(?SARS???)?stigama or
  ??????????

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SARS??V.S 921 ??

• SARS?????????? 921???????---uncertainty of a
  continued threat---how long?
• ???????? V.S??????????---???????????
• ????, ????, ??, ?? ,???????(????),???????????????
  ??????????

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SARS??V.S 921 ??

• ??921????? anxiety and depressive mood,
  somatization, obsessive-compulsion, interpersonal
  sensitivity, PTSD, major depression, adjustment
  disorder, guilt feeling, Suicide , drug
  dependence (alcohol)???????(?????? or ??)(1998/2
  ???? 1999/921??)
• What about the SARS?

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SARS??V.S 921 ??

• ?????????? Psychiatric diagnoses panic reaction,
  acute stress disorder, posttraumatic disorder,
  adjustment disorder, Bereavement, or major
  depression --- good medication and psychotherapy
  ---???????????????
• ??????????SARS, ????????
• ??? (???? 40? ??)----????