Panic Disorder Diagnosis

1. See also
   1. Panic Disorder
   2. Panic Disorder Diagnosis
   3. Panic Disorder Management
   4. Agoraphobia
   5. Anxiety Disorder
   6. Anxiety Secondary Cause
   7. Anxiety Symptoms
   8. Generalized Anxiety Disorder
   9. Obsessive Compulsive Disorder
   10. Body Dysmorphic Disorder
   11. Social Anxiety Disorder (Social Phobia)
   12. Acute Stress Disorder
   13. Post-Traumatic Stress Disorder
   14. Excessive Worry
   15. Anxiety Non-pharmacologic Management
   16. Anxiety Pharmacologic Management
2. Diagnosis
   1. Recurrent unexpected Panic Attacks
      1. Discrete episode of intense fear or discomfort with a strong sympathetic response
      2. Symptoms peak within minutes (e.g. 10 minutes)
      3. Four or more symptoms (see below)
   2. Consequences of attacks (either or both for at least 1 month)
      1. Persistent worry about future attacks or consequences
      2. Maladaptive behavior changes (e.g. avoiding unfamiliar situations)
   3. No identified alternative medical causes or substance adverse effects
      1. See Anxiety Secondary Causes
   4. No other dominant or more specific psychiatric condition to explain the symptoms
      1. Social Anxiety Disorder
      2. Specific phobias
      3. Obsessive Compulsive Disorder
      4. Posttraumatic Stress Disorder
      5. Separation Anxiety Disorder
   5. Identify whether avoidance behaviors are present
      1. Panic Disorder with Agoraphobia
      2. Panic Disorder without Agoraphobia
3. Symptoms: Criteria for Panic Disorder (4 or more required for diagnosis)
   1. Generalized
      1. Diaphoresis
      2. Chills or Hot Flushes
   2. Respiratory
      1. Shortness of Breath
      2. Sensation of Choking or smothering
   3. Cardiovascular
      1. Chest Pain
      2. Palpitations, heart pounding or Tachycardia
   4. Gastrointestinal
      1. Nausea or Abdominal distress
   5. Neurologic
      1. Dizzy, light-headed, unsteady or faint feeling
      2. Paresthesias
      3. Trembling or shaking
   6. Psychologic
      1. Sensation of foreboding: dying or heart attack
      2. Fear or losing control or going crazy
      3. Feelings of unreality (derealization) or being detached from oneself (depersonalization)
4. References
   1. APA (2013) DSM V, APA, p. 208-9
   2. Starr (November, 1998) Patient Care
   3. Katerndahl (1997) Postgrad Med, 101(1): 147-66 [PubMed]
   4. Katerndahl (1996) J Fam Pract, 43(3): 275-82 [PubMed]
   5. Rubin (1996) Phys Sportsmed, 24(12):54-65 [PubMed]
   6. Saeed (1998) Am Fam Physician, 57(10):2405-12 [PubMed]
   7. Weinstein (1995) Am Fam Physician, 52(7):2055-63 [PubMed]