Generalised anxiety disorder

Presentation and immediate needs

Difficult-to-control worry across everyday areas is accompanied by tension, restlessness, disturbed sleep or impaired concentration and functioning.

Begin assessment → History, examination and context

History, examination and context

Explore the topics, duration and controllability of worry, avoidance, reassurance seeking and functional effects. Distinguish persistent worry from discrete panic attacks or intrusive obsessions.

Consider the branch → Discrete attacks, intrusive obsessions or a specific fear pattern?

Discrete attacks, intrusive obsessions or a specific fear pattern?

Use clinical findings and collateral. Uncertainty needs clarification, not a default negative answer.

Yes / concerning features → Priority assessment; No / not established → Formulation and care discussion; Uncertain / not assessed → Obtain the missing information

Priority assessment

Clarify the relevant syndrome; do not equate every anxiety presentation with GAD.

After appropriate assessment → Formulation and care discussion

Obtain the missing information

Review the examination, timeline, relevant investigations and consented collateral. Escalate urgent concerns while uncertainty is resolved.

Reassess the branch → Discrete attacks, intrusive obsessions or a specific fear pattern?

Formulation and care discussion

Use a stepped, preference-sensitive approach including psychoeducation, structured self-help, CBT or applied relaxation, and appropriately selected medication when indicated. Address practical stressors and sleep.

Agree follow-up → Reassess and follow up

Reassess and follow up

Review worry, avoidance, sleep, function and tolerability; do not judge recovery from a score alone.