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Generalized anxiety disorder — MCCQE Part 1 MCQ

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EasyAnxietyGeneralized anxiety disorderMCCQE Part 1

39-year-old teacher presents with excessive worry for 9 months. She has muscle tension, poor sleep and restlessness across work and family domains. Which of the following is the most appropriate next step?

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Correct answer: A — Offer CBT and/or SSRI/SNRI with stepped-care follow-up

Offer CBT and/or SSRI/SNRI with stepped-care follow-up is best because persistent multi-domain worry with somatic tension suggests GAD. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Rule out thyroid disease, substance use and medication causes.

Reference: Canadian anxiety guidelines