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Panic Disorder
Panic attacks -American Description
Diagnostic Criteria:
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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:
A. Meets the criteria for Panic Disorder
B.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
A. Meets the criteria for Panic Disorder
B. Absence of Agoraphobia
Associated Features
- Depressed Mood
- Somatic/Sexual Dysfunction
- Addiction
- Anxious/Fearful/Dependent Personality
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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.
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