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Psychiatry · USMLE Step 1

USMLE Psychiatry: Anxiety and Trauma-Related Disorders

Generalized anxiety disorder, panic disorder, PTSD, and OCD diagnostic criteria tested on USMLE Step 1.

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What is the hallmark feature of generalized anxiety disorder (GAD)?
Excessive, difficult-to-control worry about multiple everyday events.
In GAD, excessive worry must occur more days than not for at least ____.
6 months
How many of the six associated somatic/cognitive symptoms must an adult have for a GAD diagnosis?
At least 3 (of restlessness, fatigue, poor concentration, irritability, muscle tension, sleep disturbance).
First-line pharmacologic treatment class for GAD?
SSRIs or SNRIs.
First-line psychotherapy for GAD?
Cognitive behavioral therapy (CBT).
What defines panic disorder?
Recurrent, unexpected panic attacks.
During a panic attack, symptoms typically peak within ____.
10 minutes
How many panic attack symptoms from the DSM-5 list are required to diagnose a panic attack?
At least 4.
Panic disorder requires at least ____ of persistent concern about additional attacks or related behavioral change after a panic attack.
1 month
Is agoraphobia diagnosed only in the presence of panic disorder in DSM-5?
No, agoraphobia is a separate diagnosis that can occur with or without panic disorder.
How many situational categories must be feared or avoided to diagnose agoraphobia?
At least 2 (e.g., public transportation, open spaces, enclosed spaces, crowds, being outside the home alone).
First-line pharmacotherapy for panic disorder?
SSRIs.
Why are benzodiazepines not used as first-line long-term therapy for panic disorder?
Risk of dependence and tolerance; reserved for short-term or acute symptom relief.
PTSD symptoms must persist for more than ____ after the traumatic event to meet diagnostic criteria.
1 month
What distinguishes acute stress disorder from PTSD?
Acute stress disorder lasts from 3 days to 1 month; PTSD requires symptoms lasting beyond 1 month.

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