A 42-year-old has excessive uncontrollable worry about work, finances, and family most days for eight months with muscle tension and insomnia. She

Question

A 42-year-old has excessive uncontrollable worry about work, finances, and family most days for eight months with muscle tension and insomnia. She has no mania, trauma syndrome, substance use, or suicidality. What is the best next treatment?

Accepted Answer

Offer cognitive behavioral therapy or an SSRI or SNRI based on preference, severity, comorbidity, and treatment access

Answer

Start long-term benzodiazepine monotherapy for anxiety, insomnia, work impairment, recurrent symptoms, and impaired daily coping

Answer

Delay structured treatment while monitoring symptoms, sleep, functioning, work performance, family stressors, medication preferences, and occupational stability

Answer

Offer antipsychotic medication for anxiety with functional impairment, insomnia, poor attendance, recurrent panic, and school disruption

Answer

Use supportive reassurance without psychotherapy, medication, crisis planning, follow-up, functional monitoring, or structured treatment goals

Generalized anxiety disorder — USMLE Step 3 MCQ

A 42-year-old has excessive uncontrollable worry about work, finances, and family most days for eight months with muscle tension and insomnia. She has no mania, trauma syndrome, substance use, or suicidality. What is the best next treatment?