A school-age child becomes frustrated when unable to perform tasks, has frequent temper tantrums, irritability, and poor sleep. Which disorder is most likely?

A school-age child becomes frustrated when unable to perform tasks, has frequent temper tantrums, irritability, and poor sleep. Which disorder is most likely?

• A. Generalized anxiety disorder (GAD)
• B. Obsessive-compulsive disorder (OCD)
• C. PANDAS
• D. Separation anxiety disorder (SAD)

Answer: (A)

Generalized anxiety in children presents as persistent, excessive worry about many everyday things that the child has difficulty controlling, often with irritability, restlessness, and sleep problems. In this scenario, the school-age child shows frustration when tasks can’t be completed, frequent temper outbursts and irritability, and poor sleep—all common signs of underlying anxiety that is broad and not tied to a single trigger. The worries and tension can manifest as tantrums and sleep disturbance as the child’s anxious thoughts intrude at bedtime and during the day. This fits better than other options because obsessive-compulsive disorder would involve intrusive thoughts and repetitive rituals to reduce anxiety, not described here. PANDAS would require an abrupt onset of OCD-like symptoms or tics following a streptococcal infection, which isn’t mentioned. Separation anxiety would center on distress about being away from caregivers or home, especially in contexts like school, rather than a general pattern of worry about multiple domains and associated irritability and sleep disturbance.

Generalized anxiety in children presents as persistent, excessive worry about many everyday things that the child has difficulty controlling, often with irritability, restlessness, and sleep problems. In this scenario, the school-age child shows frustration when tasks can’t be completed, frequent temper outbursts and irritability, and poor sleep—all common signs of underlying anxiety that is broad and not tied to a single trigger. The worries and tension can manifest as tantrums and sleep disturbance as the child’s anxious thoughts intrude at bedtime and during the day.

This fits better than other options because obsessive-compulsive disorder would involve intrusive thoughts and repetitive rituals to reduce anxiety, not described here. PANDAS would require an abrupt onset of OCD-like symptoms or tics following a streptococcal infection, which isn’t mentioned. Separation anxiety would center on distress about being away from caregivers or home, especially in contexts like school, rather than a general pattern of worry about multiple domains and associated irritability and sleep disturbance.