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Generalised anxiety disorder — MCCQE Part 1 MCQ

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HardAnxietyGeneralised anxiety disorderMCCQE Part 1

A 42-year-old teacher has 8 months of excessive uncontrollable worry about many domains, muscle tension and insomnia, with no substance use or hyperthyroidism. Which of the following is the most appropriate next step?

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Correct answer: B — Offer cognitive behavioural therapy and/or an SSRI or SNRI

Offer cognitive behavioural therapy and/or an SSRI or SNRI is the single best answer because the age, timing, examination findings and investigations in the vignette fit Generalised anxiety disorder better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian anxiety guidelines, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian anxiety guidelines