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.
Comparison
Side-by-side4 compared
Comparevs
Dimension
GAD
Panic Disorder
PTSD
OCD
Core feature
- Excessive uncontrollable worry, many domains
- Sudden discrete attacks of intense fear
- ★Re-experiencing trauma (flashbacks, nightmares)
- ★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 relaxation; set limits on worry talk
- Stay present; reassure not cardiac
- 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 adjunct
- SSRIs; short-term benzo for acute only
- SSRIs (sertraline, paroxetine) — FDA-approved
- High-dose SSRIs; clomipramine if SSRI fails
First-line therapy
- CBT with cognitive restructuring
- CBT with interoceptive exposure
- Trauma-focused CBT; prolonged exposure; EMDR
- ★ERP (exposure + response prevention) — gold std
Safety / escalate
- Comorbid depression; chronic distress
- Agoraphobia/isolation; mistaken for MI
- ★Suicidal/self-harm; substance use
- Severe ritual-driven dysfunction
Complications
- Chronic impairment; depression
- Agoraphobia; avoidance
- Chronic PTSD; substance abuse; suicide
- Severe functional impairment
Core feature
GAD
- Excessive uncontrollable worry, many domains
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 relaxation; set limits on worry talk
Panic Disorder
- Stay present; reassure not cardiac
- Coach slow breathing during attack
First-line medication
GAD
- SSRIs; buspirone adjunct
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
- Comorbid depression; chronic distress
Panic Disorder
- Agoraphobia/isolation; mistaken for MI
Complications
GAD
- Chronic impairment; depression
Panic Disorder
- Agoraphobia; avoidance
★ marks the fact that sets a column apart.
Clinical Pearl
Everything = GAD. Sudden attacks = Panic. Reliving trauma = PTSD. Rituals to silence thoughts = OCD.
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