DSM-5PanicAttackSpecifierNote:Symptoms are presentedfor the purpose of identifying a panic attack;however,panic attack isnota mental disorderand cannotbe coded.Panic attacks can occurin thecontextof any anxiety disorderas well as othermental disorders (e.g.,depressive disor-ders,posttraumatic stress disorder,substance use disorders)and some medical condi-tions(e.g.,cardiac,respiratory,vestibular,gastrointestinal).Whenthepresenceofapanicattack is identified,it should be noted as a specifier (e.g.,"posttraumatic stress disorderwithpanicattacks").Forpanic disorder,the presence of panic attackis contained withinthecriteriaforthedisorderand panicattack is notused as aspecifier.Anabruptsurge ofintensefearorintense discomfortthatreaches apeak withinminutes,andduringwhichtimefour(ormore)ofthefollowingsymptomsoccur:Note:Theabruptsurgecanoccurfromacalmstateorananxiousstate.1.Palpitations,poundingheart,oracceleratedheartrate.2.Sweating.3.Tremblingor shaking.4.Sensations of shortness of breath or smothering5.Feelings of choking6.Chestpainordiscomfort7.Nauseaorabdominaldistress.8.Feelingdizzy,unsteady,light-headed,orfaint.9.Chilis orheat sensations.10.Paresthesias(numbnessortinglingsensations)11.Derealization(feelingsofunreality)ordepersonalization(beingdetachedfromoneself)12.Fear of losing control or"going crazy."13.Fearofdying.Note:Culture-specificsymptoms(e.g.,tinnitus,necksoreness,headache,uncontrollablescreaming or crying)may be seen.Suchsymptoms shouldnotcountasone of thefourrequiredsymptoms
DSM-5
Panic disorderEpidemiologyThe lifetimeprevalenceis 1.5-3.5%, at aRates much higherny time, 1-2% of theinmedicalclinicsampopulationwill sufferples.1.5-3.7% for panicfrom the condition.Womenare2-3timesdisorder, 7-9% formorelikelytobeaffepanic attacks.ctedthanmen
Panic disorder 1.5-3.7% for panic disorder, 7-9% for panic attacks. Rates much higher in medical clinic sam ples. Women are 2-3 times more likely to be affe cted than men. The lifetime prevale nce is 1.5-3.5%, at a ny time, 1-2% of the population will suffer from the condition. Epidemiology
Panic disorderPanic disorderhasabimodaldistributionwithhighestpeakincidenceat 15-24yrs and a secondpeakat45-54yrs.Rareafterage65(0.1%)15-24yrs45-54yrs<15yrs>65yrs
Panic disorder ＞65yrs ＜15yrs 45-54yrs 15-24yrs Panic disorder has a bimodal distribution with highest peak incidence at 15-24yrs and a second peak at 45-54yrs. Rare after age 65 (0.1%)
Panic disordertreatmentpharmacologicalpsychologicalISSRIs:paroxetineCBTbehavioralmethods.AlternativeantidePsychodynamicpressantspsychotherapy.BDZs (e.g.alprazolamorclonazepam)
Panic disorder pharmacological CBT—behavioral methods. Psychodynamic psychotherapy. treatment psychological ISSRIs:paroxetine . Alternative antide pressants. BDZs (e.g. alpraz olam or clonazep am)
Panic disorderIssues of comorbidityObsessivecomsocialAlcoholdepressionpulsivephobiaabusedisorder
Issues of comorbidity depression Alcohol abuse Obsessivecom pulsive disorder social phobia Panic disorder