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Panic Disorder


 AmericanDescription
Diagnostic Criteria
Recurrent unexpected Panic Attacks
Criteria for Panic Attack:
A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
palpitations, pounding heart, or accelerated heart rate
sweating
trembling or shaking
sensations of shortness of breath or smothering
feeling of choking
chest pain or discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded, or faint
derealization (feelings of unreality) or depersonalization (being detached from oneself)
fear of losing control or going crazy
fear of dying
paresthesias (numbness or tingling sensations)
chills or hot flushes
At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
persistent concern about having additional attacks
worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
a significant change in behavior related to the attacks
The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).
The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

Panic Disorder With Agoraphobia
Meets the criteria for Panic Disorder
The presence of Agoraphobia:
Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.
Note: Consider the diagnosis of Specific Phobia if the avoidance is limited to one or only a few specific situations, or Social Phobia if the avoidance is limited to social situations.
The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.
The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment), Specific Phobia (e.g., avoidance limited to a single situation like elevators), Obsessive-Compulsive Disorder (e.g., avoidance of dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., avoidance of leaving home or relatives).

Panic Disorder Without Agoraphobia
Meets the criteria for Panic Disorder
Absence of Agoraphobia

Associated Features
Depressed Mood
Somatic/Sexual Dysfunction
Addiction
Anxious/Fearful/Dependent Personality

Differential Diagnosis
Anxiety Disorder Due to a General Medical Condition; Substance-Induced Anxiety Disorder; other Anxiety Disorder; Psychotic Disorders; Social Phobia; Specific Phobia;
Obsessive-Compulsive Disorder; Posttraumatic Stress Disorder; Separation Anxiety Disorder; Delusional Disorder.
Internet Mental Health (www.mentalhealth.com) copyright © 1995-2000 by Phillip W. Long, M.D.

 

 

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