Materiały źródłowe

• #1 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  Panic disorder is fairly common in the general population. Among all anxiety disorders, it has the highest number of medical visits and serves as a very costly mental health condition. Panic disorder is characterized by recurrent, unexpected panic attacks. Panic attacks are defined by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) as an abrupt surge of intense fear or discomfort reaching a peak within minutes. […] Making an accurate diagnosis of panic disorder is not possible without a thorough awareness of what constitutes panic attacks. […] According to DSM 5 (Fifth Edition) criteria, at least one panic attack must be followed by one month or more of persistent concern over having more attacks, worry about the consequences of the attacks or maladaptive behavior such as avoidance of work or school activities.

• #2 Panic Attacks & Panic Disorder: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

  Panic attacks are the main feature of panic disorder. […] Panic disorder is an anxiety disorder that involves multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and aren’t due to another mental health or physical condition. […] If there’s no underlying physical cause, your provider may make a diagnosis according to your symptoms and risk factors. […] Medical or mental health providers can diagnose panic disorder based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Your provider may diagnose panic disorder when you have repeated, unexpected panic attacks as well as one month or more of: Persistently worrying about having more panic attacks or their consequences. Changing your behaviors to avoid situations that you think may trigger an attack. […] In addition, the attacks can’t be due to the direct effects of a substance or general medical condition. And they can’t be better accounted for by another mental health condition, like a phobia or PTSD.

• #3 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Your primary care provider will determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, with symptoms that resemble panic attacks. […] To help pinpoint a diagnosis, you may have: A complete physical exam, Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG), A psychological evaluation to talk about your symptoms, fears or concerns, stressful situations, relationship problems, situations you may be avoiding, and family history. […] Not everyone who has panic attacks has panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points: You have frequent, unexpected panic attacks. At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; continued fear of the consequences of an attack, such as losing control, having a heart attack or „going crazy”; or significant changes in your behavior, such as avoiding situations that you think may trigger a panic attack. Your panic attacks aren’t caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive-compulsive disorder. […] If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren’t treated, they can get worse and develop into panic disorder or phobias.

• #4 [Box], EXHIBIT 4.9. Diagnostic Criteria for Panic Disorder – Substance Use Disorder Treatment for People With Co-Occurring Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK571021/box/ch4.b27/?report=objectonly

  A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur: […] B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: 1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, going crazy). 2. A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations). […] C. The disturbance is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).

• #5 [Box], EXHIBIT 4.9. Diagnostic Criteria for Panic Disorder – Substance Use Disorder Treatment for People With Co-Occurring Disorders – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK571021/box/ch4.b27/?report=objectonly

  A. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur: […] B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following: 1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, going crazy). 2. A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations). […] C. The disturbance is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).

• #6 300. 01 Panic Disorder Symptoms And Related DSM- 5 Diagnosis – Senior Care Psychological Consulting

  https://seniorcarepsychological.com/300-01-panic-disorder-symptoms-and-related-dsm-5-diagnosis/

  B. At least one of the attacks has been followed by one month (or more) of one or both of the following: 1. Persistent concern or worry about additional panic attacks or their consequences such as losing control, having a heart attack or going crazy. […] C. The disturbance is not attributable to the physiological effects of a substance such as a drug of abuse, a medication or another medical condition such as hyperthyroidism or cardiopulmonary disorders. […] D. The disturbance is not better explained by another mental disorder such as panic attacks, do not occur only in response to fear and social situations, as in social anxiety disorder; in response to circumscribed phobic objects or situations, as in specific phobia; in response to obsessions, as in obsessive-compulsive disorder; in response to reminders of traumatic events, as in posttraumatic stress disorder; or in response to separation from attachment figures, as in separation anxiety disorder.

• #7 Panic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430973/

  Panic disorder is fairly common in the general population. Among all anxiety disorders, it has the highest number of medical visits and serves as a very costly mental health condition. Panic disorder is characterized by recurrent, unexpected panic attacks. Panic attacks are defined by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) as an abrupt surge of intense fear or discomfort reaching a peak within minutes. […] Making an accurate diagnosis of panic disorder is not possible without a thorough awareness of what constitutes panic attacks. […] According to DSM 5 (Fifth Edition) criteria, at least one panic attack must be followed by one month or more of persistent concern over having more attacks, worry about the consequences of the attacks or maladaptive behavior such as avoidance of work or school activities.

• #8 Panic disorder and agoraphobia | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/panic-disorder-and-agoraphobia

  Panic disorder is not the same as anxiety or a single panic attack. […] Symptoms of panic disorder include frequent and unexpected panic attacks. […] Having early treatment is important for recovery from panic disorder or agoraphobia. […] Not everyone who has a panic attack has a panic disorder, but having recurring panic attacks is a symptom of panic disorder. […] Symptoms of panic disorder include: frequent and unexpected panic attacks, ongoing worry about having another panic attack for more than one month after the panic attack, ongoing worry about the consequences of having an attack such as losing control, going crazy or having a heart attack. […] Healthcare professionals who can diagnose a mental health condition include your GP, a psychiatrist and some psychologists. […] A diagnosis of panic disorder or agoraphobia will also involve your healthcare professional asking you questions about your symptoms and feelings, so they can understand your problem.

• #9 Panic Attacks & Disorders Q&A – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/what-is-a-panic-attack

  A panic attack is an episode of intense fear with an abrupt onset, lasting from several minutes to up to an hour. It has many mental and physical symptoms such as chest pain, shortness of breath, nausea, dizziness, chest pain and a sense of pending doom. […] Panic attacks can cause chest pain and breathing problems that lead some people to seek medical care. […] To be diagnosed as a panic attack, the episode must have at least four of these symptoms simultaneously: Chest pain or discomfort, chills or heat sensations, derealization (feelings of unreality) or depersonalization (being detached from oneself), fast beating, fluttering or pounding heart, fear of dying, fear of losing control or „going crazy”, feeling dizzy, unsteady, light-headed or faint, feelings of choking, nausea or abdominal distress, numbness or tingling sensations, sensations of shortness of breath or smothering, sweating, trembling or shaking.

• #10 Panic attacks and panic disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

  Panic attacks can be very frightening. […] But if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder. […] If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. […] Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it’s important to get evaluated by your primary care provider if you aren’t sure what’s causing your symptoms. […] Left untreated, panic attacks and panic disorder can affect almost every area of your life. […] For some people, panic disorder may include agoraphobia avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack.

• #11 Panic Disorder Test: Do I Have Panic Disorder? I Psych Central

  https://psychcentral.com/quizzes/panic-disorder-test

  If you think you may have panic disorder, consider reaching out to a healthcare or mental health professional. Treatment typically includes therapy, medication, or a combination of both. […] Only a mental health professional can diagnose panic disorder. They will likely do a physical exam first to rule out any other conditions that may be causing your symptoms. […] A psychological evaluation may be done to help understand your symptoms and determine whether panic disorder is an accurate diagnosis for what you’re experiencing. […] Panic disorder is characterized by recurrent panic attacks, a fear another panic attack will happen, or a combination of both. To be diagnosed with panic disorder, you must meet the following criteria: unexpected, recurrent panic attacks; an attack followed by 1 month or more of constant concern of additional attacks or what they may cause, or a significant behavior change brought on by the attacks. […] If these symptoms begin to interfere with your daily life, you may have a panic disorder.

• #12 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Your primary care provider will determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, with symptoms that resemble panic attacks. […] To help pinpoint a diagnosis, you may have: A complete physical exam, Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG), A psychological evaluation to talk about your symptoms, fears or concerns, stressful situations, relationship problems, situations you may be avoiding, and family history. […] Not everyone who has panic attacks has panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points: You have frequent, unexpected panic attacks. At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; continued fear of the consequences of an attack, such as losing control, having a heart attack or „going crazy”; or significant changes in your behavior, such as avoiding situations that you think may trigger a panic attack. Your panic attacks aren’t caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive-compulsive disorder. […] If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren’t treated, they can get worse and develop into panic disorder or phobias.

• #13 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. […] You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks. […] See a GP if you’ve been experiencing symptoms of panic disorder. […] They’ll ask you to describe your symptoms, how often you get them, and how long you have had them. […] They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. […] If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. […] The specialist will carry out an assessment and devise a treatment plan to help you manage your symptoms.

• #14 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Panic-Disorder-Diagnosis.aspx

  One of the most characteristic features of panic disorder is a history of frequent panic attacks and anxiety associated with fear of a future attack. However, not all individuals who experience panic attacks develop panic disorder. […] A diagnosis of panic disorder is made if a person reports a panic attack followed by at least one month of feeling severely anxious over the prospect of having another attack in the future. This time spent fearing a further attack is often associated with significant changes in a person’s behaviour, if their anxiety starts to interfere with routine daily tasks such as shopping or driving, for example. […] On visiting the doctor, details of the attacks and their frequency, triggers, onset, duration and severity are evaluated. Any previous history of phobias, anxiety disorder or traumatic life events are also noted. The patient’s current daily routines and activities are examined in detail as is any family history of panic disorder or other mental health disorders. […] A detailed physical examination to rule out the presence of any other medical conditions such as an overactive thyroid gland is performed. […] Finally, a detailed mental health evaluation to check for depression, anxiety disorder or phobias is carried out.

• #15 Panic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/121

  In panic disorder, frequency of attacks may vary widely, with some individuals reporting brief clusters of several panic episodes in a short period of time, weekly panic attacks, or periodic attacks over the course of several months. Regardless of frequency, the person remains persistently concerned or anxious about the possibility of another attack. […] Key diagnostic factors include unexpected onset, apprehension and worry, behavioral avoidance, tachycardia, positive PRIME-MD panic screen, Panic Disorder Severity Scale (PDSS), and GAD-7 cut score 10. […] Other diagnostic factors include palpitations; chest pain and discomfort; nausea and abdominal pain; dizziness; perceptual abnormality; respiratory symptoms; reliance on safety cues; paresthesias; muscle shaking; sweating; fainting; chills or hot flushes. […] 1st tests to order include clinical assessment. […] Tests to consider include ECG, blood glucose, thyroid function tests, metabolic panel, and toxicology screen.

• #16 Panic attacks and panic disorder – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/drc-20376027

  Your primary care provider will determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, with symptoms that resemble panic attacks. […] To help pinpoint a diagnosis, you may have: A complete physical exam, Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG), A psychological evaluation to talk about your symptoms, fears or concerns, stressful situations, relationship problems, situations you may be avoiding, and family history. […] Not everyone who has panic attacks has panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points: You have frequent, unexpected panic attacks. At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; continued fear of the consequences of an attack, such as losing control, having a heart attack or „going crazy”; or significant changes in your behavior, such as avoiding situations that you think may trigger a panic attack. Your panic attacks aren’t caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive-compulsive disorder. […] If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren’t treated, they can get worse and develop into panic disorder or phobias.

• #17 Panic Disorder Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/panic-disorder-test/

  A panic disorder test can help you find out if certain symptoms are caused by a panic disorder or a physical condition. This helps to make sure you get the right treatment. […] A panic disorder test is used to find out if certain symptoms are caused by a panic disorder or a physical condition, such as a heart attack. […] You may need a panic disorder test if you’ve had two or more recent panic attacks for no clear reason and are afraid of having more panic attacks. […] Your health care provider may give you a physical exam and ask you about your feelings, mood, and other symptoms. Your provider may also order blood tests and/or tests on your heart to rule out a heart attack or other physical conditions such as thyroid problems. […] To understand the results of a panic disorder test, your provider will consider your symptoms, medical history, and the results of other tests. Symptoms of panic disorder often begin before age 25 but may occur in the mid-30s and include: Frequent, unexpected panic attacks, ongoing worry about having another panic attack, avoiding places and situations because you’re worried that they may cause a panic attack, fear of losing control, no other cause of a panic attack, such as substance use, a mental health condition or physical condition.

• #18 Panic Disorder Workup: Approach Considerations, Diagnostic Studies, Radiologic Studies

  https://emedicine.medscape.com/article/287913-workup

  No invasive procedures are required to diagnose panic disorder, although they may be useful in eliminating other conditions in the differential diagnosis. As previously mentioned, history, collateral information, physical examination, and a mental status examination remain the diagnostic cornerstones for panic disorder. […] Laboratory studies that can exclude medical disorders other than panic disorder include the following: Serum electrolytes to exclude hypokalemia and acidosis, Serum glucose to exclude hypoglycemia, Cardiac enzymes in patients suspected of acute coronary syndromes, Serum hemoglobin in patients with near-syncope, Thyroid-stimulating hormone (TSH) in patients suspected of hyperthyroidism, Urine toxicology screen for amphetamines, cannabis, cocaine, and phencyclidine in patients suspected of intoxication, D-dimer assay to exclude pulmonary embolism. […] No imaging study findings are currently specific for panic disorder, although they are performed to evaluate anatomic evidence of other diagnostic possibilities. Studies may include an electroencephalogram (EEG) to exclude partial complex seizures.

• #19 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  Generalized anxiety disorder (GAD) and panic disorder (PD) are common mental health conditions in adults that are often seen in primary care. […] The GAD-7 and Patient Health Questionnaire for PD are validated screening tools that can aid in diagnosis and assessment. […] GAD is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) as excessive worry that occurs on most days for at least six months and causes significant distress or impairment. […] PD is defined by the DSM-5 as recurrent panic attacks that include characteristic symptoms and lack an obvious trigger. […] The symptoms of GAD and PD can suggest medical diagnoses, including hyperthyroidism, arrhythmias, asthma, chronic obstructive pulmonary disease, certain medication use or withdrawal, and substance use or withdrawal.

• #20 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  PD is characterized by episodic, unexpected panic attacks that occur without a clear trigger. Panic attacks are defined by the rapid onset of intense fear (typically peaking within about 10 minutes) with at least four of the physical and psychological symptoms in the DSM-5 diagnostic criteria. Another requirement for the diagnosis of PD is that the patient worries about further attacks or modifies his or her behavior in maladaptive ways to avoid them. The most common physical symptom accompanying panic attacks is palpitations. […] When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations. Other psychiatric disorders (e.g., other anxiety disorders, major depressive disorder, bipolar disorder); use of substances such as caffeine, albuterol, levothyroxine, or decongestants; or substance withdrawal may also present with similar symptoms and should be ruled out.

• #21 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  GAD and PD commonly occur with other psychiatric conditions, including major depressive episodes, manic-hypomanic episodes, dysthymia, and substance use disorder. […] There is insufficient evidence to support universal screening for GAD or PD in adults at this time; however, the U.S. Preventive Services Task Force is updating guidelines regarding screening for anxiety, suicidality, and depression. […] The Patient Health Questionnaire for PD is the most accurate screening tool for PD in patients expressing sudden episodes of anxiety or fear. […] Antidepressants, SSRIs and SNRIs in particular, are considered first-line therapies for GAD and PD because they are effective and generally well tolerated. […] Benzodiazepines are not more effective than antidepressants for treating anxiety disorders and should not be used as first-line therapy. […] Psychotherapy is as effective as pharmacotherapy for treating PD and GAD and can be used alone or combined with pharmacotherapy for anxiety disorders, with combination treatment likely to be more effective than either treatment alone.

• #22 Panic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/121

  In panic disorder, frequency of attacks may vary widely, with some individuals reporting brief clusters of several panic episodes in a short period of time, weekly panic attacks, or periodic attacks over the course of several months. Regardless of frequency, the person remains persistently concerned or anxious about the possibility of another attack. […] Key diagnostic factors include unexpected onset, apprehension and worry, behavioral avoidance, tachycardia, positive PRIME-MD panic screen, Panic Disorder Severity Scale (PDSS), and GAD-7 cut score 10. […] Other diagnostic factors include palpitations; chest pain and discomfort; nausea and abdominal pain; dizziness; perceptual abnormality; respiratory symptoms; reliance on safety cues; paresthesias; muscle shaking; sweating; fainting; chills or hot flushes. […] 1st tests to order include clinical assessment. […] Tests to consider include ECG, blood glucose, thyroid function tests, metabolic panel, and toxicology screen.

• #23 Panic disorder – Wikipedia

  https://en.wikipedia.org/wiki/Panic_disorder

  Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. […] Diagnosis involves ruling out other potential causes of anxiety including other mental disorders, medical conditions such as heart disease or hyperthyroidism, and drug use. […] The DSM-IV-TR diagnostic criteria for panic disorder require unexpected, recurrent panic attacks, followed in at least one instance by at least a month of a significant and related behavior change, a persistent concern of more attacks, or a worry about the attack’s consequences. […] Panic disorder should not be given as the main diagnosis if the person has a depressive disorder at the time the attacks start; in these circumstances, the panic attacks are probably secondary to depression. […] The Panic Disorder Severity Scale (PDSS) is a questionnaire for measuring the severity of panic disorder.

• #24 Panic Disorder Screener (PADIS) | ANU National Centre for Epidemiology and Population Health

  https://nceph.anu.edu.au/research/tools-resources/panic-disorder-screener–padis

  The Panic Disorder Screener (PADIS) is a brief tool designed to identify symptoms of panic disorder, enabling early diagnosis and appropriate intervention to improve mental health care. […] This scale is designed to screen individuals in the community for presence of panic disorder and severity of panic disorder symptoms. […] The PADIS has been validated in a community-based sample of young Australians aged 18-30 (n = 12,336), with accuracy compared to diagnostic interview (social phobia caseness on the Mini International Neuropsychiatric Interview) in a subsample of 1,674 with elevated anxiety symptoms. […] Using a cut-off score of 4 or higher to indicate criteria for panic disorder, the PADIS had 77% sensitivity and 84% specificity, with higher sensitivity but lower specificity compared to the PHQ-Panic scale (57% sensitivity, 91% specificity). In an independent adult population-based sample, the PADIS had 84% sensitivity and 77% specificity compared to DSM-5 criteria, using the same criteria (PADIS=4).

• #25 Panic Disorder Differential Diagnoses

  https://emedicine.medscape.com/article/287913-differential

  An understanding of panic disorder is particularly important for emergency physicians because patients with this condition frequently present to the ED with various somatic complaints. Many of the symptoms of an anxiety attack correspond with symptomatology found in life-threatening medical disorders, such as myocardial infarction (MI) and pulmonary embolus, which may manifest with anxiety as a primary symptom. Approximately 25% of patients who present to an emergency department with chest pain have panic anxiety disorder and few individuals with panic disorder are referred to mental health professionals. […] When making a diagnosis, keep in mind the symptomatology of medical conditions such as the following: […] In addition, consider other mental illnesses that may result in panic attacks, including schizophrenia, bipolar disorder, depressive disorder, posttraumatic stress disorder, phobias, and somatization disorder.

• #26 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders. […] Medication or psychotherapy is a reasonable initial treatment option for GAD and PD. Some studies suggest that combining medication and psychotherapy may be more effective for patients with moderate to severe symptoms. […] Psychotherapy is as effective as medication for GAD and PD. Although existing evidence is insufficient to draw conclusions about many psychotherapeutic interventions, structured CBT interventions have consistently proven effective for the treatment of anxiety in the primary care setting. […] For patients with GAD or PD, psychiatric referral may be indicated if there is poor response to treatment, atypical presentation, or concern for significant comorbid psychiatric illness.

• #27 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders. […] Medication or psychotherapy is a reasonable initial treatment option for GAD and PD. Some studies suggest that combining medication and psychotherapy may be more effective for patients with moderate to severe symptoms. […] Psychotherapy is as effective as medication for GAD and PD. Although existing evidence is insufficient to draw conclusions about many psychotherapeutic interventions, structured CBT interventions have consistently proven effective for the treatment of anxiety in the primary care setting. […] For patients with GAD or PD, psychiatric referral may be indicated if there is poor response to treatment, atypical presentation, or concern for significant comorbid psychiatric illness.

• #28 Panic Disorder – PsychDB

  https://www.psychdb.com/anxiety/panic

  A panic attack can be expected or unexpected, but in order to diagnose panic disorder, there must be at least one unexpected panic attack! […] The panic attacks do not occur only in response to feared social situations (social anxiety disorder) […] Panic disorder should not be diagnosed if full-symptom (i.e. – unexpected) panic attacks have never been experienced. […] Panic disorder is characterized by recurrent unexpected panic attacks, and the unexpected nature of the panic attacks is a defining feature of the disorder. If the panic attacks typically only occur in response to specific triggers, then only the relevant anxiety disorder is assigned. However, if the individual experiences unexpected panic attacks as well and then begins to show persistent concern and worry or begins making behavioural change because of the attacks, then an additional diagnosis of panic disorder may be considered.

• #29 Panic Disorders: Symptoms, Core patterns, and Diagnostic Considerations | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/panic-disorders-symptoms-core-patterns-and-diagnostic-considerations.27630/

  In fact, many people suffering from panic attacks do not know that they have a real and treatable disorder. […] One of the main problems with panic disorder is not the danger presented by symptoms themselves; rather, it is the person’s fears of symptoms of anxiety, also termed “anxiety sensitivity”. […] A panic attack is different from a fear reaction. […] Panic attacks occur in the context of several different anxiety orders, so it is important to distinguish between two different types of attacks in order to make an accurate diagnosis.

• #30 Panic Disorder – PsychDB

  https://www.psychdb.com/anxiety/panic

  Panic disorder is a condition where there are recurrent unexpected panic attacks, in the absence of triggers. It is marked by persistent concern about additional panic attacks and/or maladaptive change in behaviour related to the attacks. […] A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time at least 4 of the following symptoms occur: Sweating, Trembling or shaking, Unsteady, dizziness, light-headed, or faint, Derealization (feelings of unreality) or depersonalization (being detached from one self), Excessive/accelerated heart rate, palpitations, or pounding heart, Nausea or abdominal distress, Tingling, numbness, parathesesias, Shortness of breath, Fear of losing control or going crazy, Fear of dying, Choking feelings, Chest pain or discomfort, Chills or heat sensations.

• #31 Panic Disorder – PsychDB

  https://www.psychdb.com/anxiety/panic

  A panic attack can be expected or unexpected, but in order to diagnose panic disorder, there must be at least one unexpected panic attack! […] The panic attacks do not occur only in response to feared social situations (social anxiety disorder) […] Panic disorder should not be diagnosed if full-symptom (i.e. – unexpected) panic attacks have never been experienced. […] Panic disorder is characterized by recurrent unexpected panic attacks, and the unexpected nature of the panic attacks is a defining feature of the disorder. If the panic attacks typically only occur in response to specific triggers, then only the relevant anxiety disorder is assigned. However, if the individual experiences unexpected panic attacks as well and then begins to show persistent concern and worry or begins making behavioural change because of the attacks, then an additional diagnosis of panic disorder may be considered.

• #32 Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0501/p617.html

  Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders. […] Medication or psychotherapy is a reasonable initial treatment option for GAD and PD. Some studies suggest that combining medication and psychotherapy may be more effective for patients with moderate to severe symptoms. […] Psychotherapy is as effective as medication for GAD and PD. Although existing evidence is insufficient to draw conclusions about many psychotherapeutic interventions, structured CBT interventions have consistently proven effective for the treatment of anxiety in the primary care setting. […] For patients with GAD or PD, psychiatric referral may be indicated if there is poor response to treatment, atypical presentation, or concern for significant comorbid psychiatric illness.

• #33 Generalized Anxiety Disorder and Panic Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0800/generalized-anxiety-disorder-panic-disorder.html

  GAD and PD commonly occur with other psychiatric conditions, including major depressive episodes, manic-hypomanic episodes, dysthymia, and substance use disorder. […] There is insufficient evidence to support universal screening for GAD or PD in adults at this time; however, the U.S. Preventive Services Task Force is updating guidelines regarding screening for anxiety, suicidality, and depression. […] The Patient Health Questionnaire for PD is the most accurate screening tool for PD in patients expressing sudden episodes of anxiety or fear. […] Antidepressants, SSRIs and SNRIs in particular, are considered first-line therapies for GAD and PD because they are effective and generally well tolerated. […] Benzodiazepines are not more effective than antidepressants for treating anxiety disorders and should not be used as first-line therapy. […] Psychotherapy is as effective as pharmacotherapy for treating PD and GAD and can be used alone or combined with pharmacotherapy for anxiety disorders, with combination treatment likely to be more effective than either treatment alone.

• #34 Panic disorder – Wikipedia

  https://en.wikipedia.org/wiki/Panic_disorder

  Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. […] Diagnosis involves ruling out other potential causes of anxiety including other mental disorders, medical conditions such as heart disease or hyperthyroidism, and drug use. […] The DSM-IV-TR diagnostic criteria for panic disorder require unexpected, recurrent panic attacks, followed in at least one instance by at least a month of a significant and related behavior change, a persistent concern of more attacks, or a worry about the attack’s consequences. […] Panic disorder should not be given as the main diagnosis if the person has a depressive disorder at the time the attacks start; in these circumstances, the panic attacks are probably secondary to depression. […] The Panic Disorder Severity Scale (PDSS) is a questionnaire for measuring the severity of panic disorder.

• #35 Panic Disorder | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/26587

  Antidepressants and benzodiazepines are the mainstays of pharmacologic treatment. […] SSRIs are considered the first-line treatment option for patients with panic disorder. […] Prognosis can be guarded. The presence of panic disorder without other psychopathology is rare. […] Panic disorder is associated with a higher risk of suicidal ideation. […] It is important for a provider to inform the patient about the symptoms that he may suffer from if he is diagnosed with the disorder. […] The majority of patients with panic disorder present to the emergency department, and hence the role of the nurse and emergency clinician cannot be overemphasized. […] Panic disorder has no cure, and its course is unpredictable. The currently available pharmacological therapy and cognitive behavior therapy does work in about 80% of patients, but relapses are common.

• #36 Panic Disorder and Panic Attacks Therapy | Amen Clinics Amen Clinics

  https://www.amenclinics.com/conditions/panic-disorder/

  This is why it is so important to look at the brain to identify underlying brain patterns associated with the condition. Functional brain imaging with SPECT, which measures blood flow and activity in the brain, lets you see what is happening in your brain so a plan can be personalized for your brain type to help you feel better.

• #37 Panic Disorder and Panic Attacks Therapy | Amen Clinics Amen Clinics

  https://www.amenclinics.com/conditions/panic-disorder/

  Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to identify brain patterns associated with panic disorder and panic attacks. […] Panic disorder is a type of anxiety disorder in which a person experiences recurrent panic attacks. […] Panic disorder increases your risk of other mental health disorders, including: […] In traditional psychiatry, where diagnoses are based solely on symptom clusters, it is not uncommon for panic disorder to be misdiagnosed. […] Finding an integrative practitioner who performs lab tests to check for these possible contributing factors can be key to getting a complete and accurate diagnosis. […] Unfortunately, traditional psychiatry typically takes a one-size-fits-all approach to diagnosis and treatment.

• #38 Panic disorder difficult to diagnose but very treatable | UW News

  https://www.washington.edu/news/2006/06/01/panic-disorder-difficult-to-diagnose-but-very-treatable/

  Panic disorder is fairly common, and can cause frightening symptoms that resemble those of heart, respiratory and gastrointestinal problems, according to a review by a University of Washington psychiatrist in the June 1 issue of the New England Journal of Medicine. […] But even though it can be difficult to diagnose, panic disorder is very treatable and most patients can be cured within just four to eight weeks. […] Panic disorder is definitely diagnosable, and treatable people can usually be cured in four to eight weeks with either antidepressant medication or behavioral therapy, or a combination of the two. […] Incorporating mental health professionals into primary-care settings can lead to physicians more quickly identifying and effectively treating patients with panic disorder, even when those patients may be exhibiting frightening symptoms.

• #39 Panic disorder and agoraphobia | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/panic-disorder-and-agoraphobia

  Panic disorder is not the same as anxiety or a single panic attack. […] Symptoms of panic disorder include frequent and unexpected panic attacks. […] Having early treatment is important for recovery from panic disorder or agoraphobia. […] Not everyone who has a panic attack has a panic disorder, but having recurring panic attacks is a symptom of panic disorder. […] Symptoms of panic disorder include: frequent and unexpected panic attacks, ongoing worry about having another panic attack for more than one month after the panic attack, ongoing worry about the consequences of having an attack such as losing control, going crazy or having a heart attack. […] Healthcare professionals who can diagnose a mental health condition include your GP, a psychiatrist and some psychologists. […] A diagnosis of panic disorder or agoraphobia will also involve your healthcare professional asking you questions about your symptoms and feelings, so they can understand your problem.

• #40 Panic disorder in adults: Treatment overview – UpToDate

  https://www.uptodate.com/contents/panic-disorder-in-adults-treatment-overview

  Panic disorder is characterized by recurrent, unexpected panic attacks along with one month of either worry about future attacks or the consequences of attacks (eg, medical concerns), or a significant change in behavior due to the attacks (eg, phobic avoidance or repetitive seeking of medical evaluations). […] Panic disorder is a relatively common disorder, most often with an adult onset and chronic course. […] The disorder can be effectively treated with cognitive-behavioral therapy, medication, or a combination of the two modalities. […] An algorithm describes our initial management decisions for panic disorder. […] Once a diagnosis of panic disorder is made, our next step is to determine, based on clinical assessment of severity of illness, extent of distress or impairment, and patient preference, whether treatment of the disorder is needed.

• #41 Panic Attacks and Panic Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/panic-attacks-and-panic-disorder

  Panic disorder is treated with pharmacotherapy, psychotherapy (eg, exposure therapy, cognitive-behavioral therapy), or both. […] Diagnosis is based on clinical criteria. […] Panic disorder is diagnosed after general medical disorders that can mimic anxiety are eliminated, and when symptoms meet diagnostic criteria stipulated in the DSM-5-TR. […] Patients have recurrent panic attacks (frequency is not specified) in which 1 attack has been followed by one or both of the following for 1 month: Persistent worry about having additional panic attacks or worry about their consequences (eg, losing control, going crazy) […] Maladaptive behavioral response to the panic attacks (eg, avoiding common activities such as exercise or social situations to try to prevent further attacks).

• #42 Panic disorder difficult to diagnose but very treatable | UW News

  https://www.washington.edu/news/2006/06/01/panic-disorder-difficult-to-diagnose-but-very-treatable/

  Panic disorder is fairly common, and can cause frightening symptoms that resemble those of heart, respiratory and gastrointestinal problems, according to a review by a University of Washington psychiatrist in the June 1 issue of the New England Journal of Medicine. […] But even though it can be difficult to diagnose, panic disorder is very treatable and most patients can be cured within just four to eight weeks. […] Panic disorder is definitely diagnosable, and treatable people can usually be cured in four to eight weeks with either antidepressant medication or behavioral therapy, or a combination of the two. […] Incorporating mental health professionals into primary-care settings can lead to physicians more quickly identifying and effectively treating patients with panic disorder, even when those patients may be exhibiting frightening symptoms.

• #43 Panic Disorder | Mental Health America

  https://mhanational.org/conditions/panic-disorder/

  Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress. These sensations often mimic symptoms of a heart attack or other life-threatening medical conditions. As a result, the diagnosis of panic disorder is frequently not made until extensive and costly medical procedures fail to provide a correct diagnosis or relief. […] Treatment for panic disorder includes medication, psychotherapy or a combination of the two. Cognitive-behavioral therapy, a type of psychotherapy, teaches people how to view panic attacks differently and demonstrates ways to reduce anxiety. Appropriate treatment by an experienced professional can reduce or prevent panic attacks in 70 to 90% of people with panic disorder. Most patients show significant progress after a few weeks of therapy. Relapses may occur, but they can often be effectively treated just like the initial episode.

• #44 Panic Disorder Differential Diagnoses

  https://emedicine.medscape.com/article/287913-differential

  An understanding of panic disorder is particularly important for emergency physicians because patients with this condition frequently present to the ED with various somatic complaints. Many of the symptoms of an anxiety attack correspond with symptomatology found in life-threatening medical disorders, such as myocardial infarction (MI) and pulmonary embolus, which may manifest with anxiety as a primary symptom. Approximately 25% of patients who present to an emergency department with chest pain have panic anxiety disorder and few individuals with panic disorder are referred to mental health professionals. […] When making a diagnosis, keep in mind the symptomatology of medical conditions such as the following: […] In addition, consider other mental illnesses that may result in panic attacks, including schizophrenia, bipolar disorder, depressive disorder, posttraumatic stress disorder, phobias, and somatization disorder.

• #45 Panic attacks and panic disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

  Panic attacks can be very frightening. […] But if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder. […] If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. […] Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it’s important to get evaluated by your primary care provider if you aren’t sure what’s causing your symptoms. […] Left untreated, panic attacks and panic disorder can affect almost every area of your life. […] For some people, panic disorder may include agoraphobia avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack.

• #46 Panic disorder diagnosis – Mental Health UK

  https://mentalhealth-uk.org/help-and-information/conditions/panic-disorder/diagnosis/

  It must not be better explained by another mental disorder, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), specific phobia, generalised anxiety disorder (GAD), or separation anxiety disorder. It must also not be due to another health condition, or caused by substance use such as medication or drug use. […] It may feel like your symptoms cannot improve, but treatment and recovery from panic disorder is possible.

• #47 Panic Attacks & Disorders Q&A – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/what-is-a-panic-attack

  A person with ongoing, unexpected panic attacks who spends time worrying about another panic attack may have a panic disorder. People with panic disorders may be afraid of experiencing more panic attacks and live in a constant state of fear that affects the quality of their lives. […] Is there a test for panic disorder? No. There is no test, but your health care team can determine if you have panic disorder or another condition based on your symptoms. […] Yes, treatment can reduce the intensity and frequency of panic attacks and panic disorder.

• #48 Take a Free Panic Disorder Test | Talkspace

  https://www.talkspace.com/assessments/panic-disorder-test

  While panic disorder may not go away completely, it can be managed and treated. If you’re struggling with ongoing panic attacks, meet with a mental health professional to help understand your symptoms and develop coping strategies. […] If you frequently find yourself asking, „do I have panic disorder,” a licensed professional can administer a clinical diagnosis, while our online panic disorder test acts as a helpful first step toward gaining clarity and seeking treatment. […] A licensed mental health professional, such as a mental health counselor, independent social worker, psychologist, psychiatrist, or a psychiatric nurse practitioner can help diagnose treat panic attacks. […] Talkspace providers treat panic disorders with a variety of evidence-based therapeutic intervention methods, with the most common method being Cognitive Behavioral Therapy (CBT). If medically appropriate, an online psychiatrist may prescribe medication to help with panic disorder symptoms.

• #49 Panic disorders – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/121

  Frequency of panic attacks may vary considerably in panic disorder, with some individuals reporting brief clusters of several panic episodes in a short period of time, weekly panic attacks, or periodic attacks over the course of several months. […] Assessment is made through ruling out organic causes; self-report; clinical interview; and behavioral observation. […] Panic disorder is characterized by recurring unexpected panic attacks over a 1-month period. People with panic disorder are persistently concerned about having another panic attack, and/or about the consequences of this (e.g., having a heart attack or losing control). […] For a diagnosis of panic disorder, panic attacks must be recurrent; note that nonrecurrent panic attacks are relatively common in the general population.

• #50 Panic Attacks and Panic Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/panic-attacks-and-panic-disorder

  Panic disorder is treated with pharmacotherapy, psychotherapy (eg, exposure therapy, cognitive-behavioral therapy), or both. […] Diagnosis is based on clinical criteria. […] Panic disorder is diagnosed after general medical disorders that can mimic anxiety are eliminated, and when symptoms meet diagnostic criteria stipulated in the DSM-5-TR. […] Patients have recurrent panic attacks (frequency is not specified) in which 1 attack has been followed by one or both of the following for 1 month: Persistent worry about having additional panic attacks or worry about their consequences (eg, losing control, going crazy) […] Maladaptive behavioral response to the panic attacks (eg, avoiding common activities such as exercise or social situations to try to prevent further attacks).

• #51 Take a Free Panic Disorder Test | Talkspace

  https://www.talkspace.com/assessments/panic-disorder-test

  While panic disorder may not go away completely, it can be managed and treated. If you’re struggling with ongoing panic attacks, meet with a mental health professional to help understand your symptoms and develop coping strategies. […] If you frequently find yourself asking, „do I have panic disorder,” a licensed professional can administer a clinical diagnosis, while our online panic disorder test acts as a helpful first step toward gaining clarity and seeking treatment. […] A licensed mental health professional, such as a mental health counselor, independent social worker, psychologist, psychiatrist, or a psychiatric nurse practitioner can help diagnose treat panic attacks. […] Talkspace providers treat panic disorders with a variety of evidence-based therapeutic intervention methods, with the most common method being Cognitive Behavioral Therapy (CBT). If medically appropriate, an online psychiatrist may prescribe medication to help with panic disorder symptoms.

• #52 Panic disorder difficult to diagnose but very treatable | UW News

  https://www.washington.edu/news/2006/06/01/panic-disorder-difficult-to-diagnose-but-very-treatable/

  Panic disorder is fairly common, and can cause frightening symptoms that resemble those of heart, respiratory and gastrointestinal problems, according to a review by a University of Washington psychiatrist in the June 1 issue of the New England Journal of Medicine. […] But even though it can be difficult to diagnose, panic disorder is very treatable and most patients can be cured within just four to eight weeks. […] Panic disorder is definitely diagnosable, and treatable people can usually be cured in four to eight weeks with either antidepressant medication or behavioral therapy, or a combination of the two. […] Incorporating mental health professionals into primary-care settings can lead to physicians more quickly identifying and effectively treating patients with panic disorder, even when those patients may be exhibiting frightening symptoms.

• #53 Panic disorder – NHS

  https://www.nhs.uk/mental-health/conditions/panic-disorder/

  Panic disorder is an anxiety disorder where you regularly have sudden attacks of panic or fear. […] You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks. […] See a GP if you’ve been experiencing symptoms of panic disorder. […] They’ll ask you to describe your symptoms, how often you get them, and how long you have had them. […] They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. […] If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. […] The specialist will carry out an assessment and devise a treatment plan to help you manage your symptoms.

• #54 Panic disorder diagnosis – Mental Health UK

  https://mentalhealth-uk.org/help-and-information/conditions/panic-disorder/diagnosis/

  If your experience with anxiety or panic attacks is affecting your everyday life, you should make an appointment to speak with your GP. They may perform some tests to check if another health condition may be causing your symptoms such as heart or thyroid issues. They may also refer you to a mental health professional for a full assessment. […] A mental health professional will diagnose panic disorder based on criteria in the International Classification of Diseases 11th Revision (ICD-11) developed by the World Health Organisation. For a diagnosis of panic disorder the individual must have experienced repeated and unexpected panic attacks as well as one month or more of the following: Persistent worry about having further panic attacks. Changing behaviours to avoid situations that may trigger an attack.

Zobacz więcej