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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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.

Component Topics

Generalized Anxiety Disorder & Panic DisorderOCD — Obsessive-Compulsive DisorderPTSD — Post-Traumatic Stress Disorder

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