multi class comparison
Anxiety Disorders: GAD vs Panic Disorder vs PTSD vs OCD — Symptom Clusters and Treatment
The NCLEX gives you a vignette with an anxious client and four diagnosis-based answer choices. If you can't match the symptom cluster to the correct disorder in seconds — chronic worry vs. sudden attacks vs. flashbacks vs. rituals — you'll pick the wrong nursing intervention every time.
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Side-by-side4 compared
Focus
Comparevs
Dimension
GAD
Panic Disorder
PTSD
OCD
Core feature
- Excessive worry about many things
- Sudden discrete attacks of intense fear
- ★Re-experiencing trauma (flashbacks)
- ★Obsessions + compulsive rituals
Signs & symptoms
- Muscle tension, restlessness, fatigue
- Insomnia, GI distress
- ★Chest pain, palpitations, dyspnea
- Fear of dying
- peaks in ~10 min
- Hypervigilance, exaggerated startle
- Avoids trauma reminders
- nightmares
- Anxiety spikes when ritual is blocked
- Skin breakdown from handwashing
Duration / criterion
- ≥ 6 months worry, more days than not
- Recurrent attacks + ≥ 1 mo fear of next
- Symptoms > 1 month post-trauma
- Rituals ≥ 1 hr/day
- marked distress
Nursing intervention
- Teach progressive muscle relaxation
- set limits on worry talk
- Stay with patient during attack
- Reassure once cardiac ruled out
- Coach slow breathing during attack
- Establish safety
- predictable routine
- Don't pressure trauma disclosure
- Allow time for rituals initially
- Do not forcibly interrupt compulsions
First-line medication
- SSRIs
- Buspirone: GAD-specific, slow onset
- SSRIs
- short-term benzo for acute only
- SSRIs
- Avoid benzodiazepines
- SSRIs
- Needs higher SSRI doses
- clomipramine if SSRI fails
First-line therapy
- CBT with cognitive restructuring
- CBT with interoceptive exposure
- Trauma-focused CBT
- prolonged exposure
- EMDR
- ★Exposure + response prevention (ERP)
Safety / escalate
- Screen for suicide risk
- Screen for suicide risk
- Rule out MI first
- Screen for suicide risk
- Reckless, self-destructive behavior
- Screen for suicide risk
Complications
- Comorbid depression
- Chronic, waxing-waning course
- Comorbid depression
- Agoraphobia, avoidance
- Comorbid depression
- Substance use disorder
- Comorbid depression
- Severe functional impairment
Core feature
GAD
- Excessive worry about many things
Panic Disorder
- Sudden discrete attacks of intense fear
Signs & symptoms
GAD
- Muscle tension, restlessness, fatigue
- Insomnia, GI distress
Panic Disorder
- ★Chest pain, palpitations, dyspnea
- Fear of dying
- peaks in ~10 min
Duration / criterion
GAD
- ≥ 6 months worry, more days than not
Panic Disorder
- Recurrent attacks + ≥ 1 mo fear of next
Nursing intervention
GAD
- Teach progressive muscle relaxation
- set limits on worry talk
Panic Disorder
- Stay with patient during attack
- Reassure once cardiac ruled out
- Coach slow breathing during attack
First-line medication
GAD
- SSRIs
- Buspirone: GAD-specific, slow onset
Panic Disorder
- SSRIs
- short-term benzo for acute only
First-line therapy
GAD
- CBT with cognitive restructuring
Panic Disorder
- CBT with interoceptive exposure
Safety / escalate
GAD
- Screen for suicide risk
Panic Disorder
- Screen for suicide risk
- Rule out MI first
Complications
GAD
- Comorbid depression
- Chronic, waxing-waning course
Panic Disorder
- Comorbid depression
- Agoraphobia, avoidance
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Clinical Pearl
Everything = GAD. Sudden attacks = Panic. Reliving trauma = PTSD. Rituals to silence thoughts = OCD.
Component Topics
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