Anxiety and related disorders: late-onset anxiety: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Anxiety and related disorders: late-onset anxiety

Sample item

A 68-year-old woman with no earlier psychiatric history develops new, marked anxiety over a few weeks. What is the most appropriate approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Look for medical, drug-related or depressive causes

First onset of anxiety in late life is more often secondary to physical illness (hyperthyroidism, cardiac or respiratory disease), drugs (steroids, theophylline, withdrawal of sedatives) or depression than a primary anxiety disorder. These should be sought before treating.

Option by option

  • A. Assume a lifelong anxiety disorder from childhood

    Primary anxiety disorders generally begin earlier in life, so this assumption is unfounded.

  • B. Look for medical, drug-related or depressive causes (correct)

    Correct. New late-life anxiety should prompt a search for medical, drug and depressive causes.

  • C. Reassure her that ageing causes anxiety

    Anxiety is not a normal part of ageing, and reassurance alone would miss treatable causes.

  • D. Start long-term diazepam immediately

    Long-term diazepam causes falls and confusion in the elderly and does not treat the cause.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Look for medical, drug-related or depressive causes. First onset of anxiety in late life is more often secondary to physical illness (hyperthyroidism, cardiac or respiratory disease), drugs (steroids, theophylline, withdrawal of sedatives) or depression than a primary anxiety disorder.

Why is "Assume a lifelong anxiety disorder from childhood" not the answer?

Primary anxiety disorders generally begin earlier in life, so this assumption is unfounded.

Why is "Reassure her that ageing causes anxiety" not the answer?

Anxiety is not a normal part of ageing, and reassurance alone would miss treatable causes.

Why is "Start long-term diazepam immediately" not the answer?

Long-term diazepam causes falls and confusion in the elderly and does not treat the cause.

What concept does this question test?

It tests Anxiety and related disorders: late-onset anxiety in Psychiatry. These should be sought before treating.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anxiety and related disorders: late-onset anxiety?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.