Treatment
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General principles.
As with all psychiatric disorders a careful history needs to be taken. Particular attention being paid to physiological, emotional, cognitive and behavioural aspects. Physical illness needs to be excluded e.g. tachycardia and weight loss may be due to hyperthyroidism; palpitation and other panic symptoms may be due to mitral valve prolapse; sweating, tachycardia etc. may be due to a phaeochromocytoma. The presence of other psychiatric disorder needs to be explored.
Physical investigations may be necessary where the history suggests physical illness, however, needless investigations in hypochondriasis, to reassure the physician, may reinforce anxiety in these patients.
Address social problems as well as using specific approaches e.g. poor housing, financial problems. Always explore the topic of substance misuse.
Avoid use of benzodiazepines.
Specific management of disorders is considered under each heading:
- Generalised anxiety disorder
- Panic disorder
- Phobic disorders
- Obsessive compulsive disorders
- Hyperventilation syndrome
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