Panic attacks and GAD — CCE clinical encounter

Objectives

1. Stage severity and diagnosis with GAD-14 (GAD-7 plus PHQ-9) while explaining what negative screens do not exclude. ^[3]
2. Exclude medical mimics — thyroid, cardiac, caffeine, substances — before fixing the label. ^[16]
3. Deliver NICE stepped care: education and active monitoring versus low-intensity versus high-intensity options matched to severity. ^[1]
4. Counsel sertraline initiation honestly: slow onset in anxiety, activation risk, start-low-go-slow titration, twelve-month continuation after response. ^{[5] [1]}
5. Address panic-specific management: interoceptive exposure within CBT; no long-term benzodiazepines. ^[10]