The PMHNP is evaluating a new patient, a 33-year-old woman. She reports feeling "keyed up" most of the time, having constant muscle tension, and excessively worrying about "every little thing." These symptoms have been occurring for about 9 months, and they are causing her significant distress at home and at work. She takes no medications, and her lab work and physical exam are negative for an underlying medical cause for these symptoms. What diagnosis is most likely?

Choice A reason: OCD is characterized by obsessions and compulsions. While this patient reports persistent worry, she does not describe intrusive thoughts or ritualistic behaviors typical of OCD. Choice B reason: Social anxiety disorder is marked by fear and avoidance of social situations. This patient’s worry is pervasive and not limited to social performance. Choice C reason: This is correct. Generalized anxiety disorder involves chronic, excessive worry across multiple domains for at least six months, accompanied by physical symptoms such as muscle tension, restlessness, and difficulty concentrating, which matches this patient’s presentation. Choice D reason: Panic disorder is defined by recurrent, unexpected panic attacks with somatic symptoms. This patient’s anxiety is ongoing and generalized, rather than episodic panic attacks.