Psychiatry » Neuroses

Panic disorder

The patient has at least four panic attacks in a 4-week period. The panic attacks are not associated with a specific situation or certain circumstances and they are unpredictable. The panic attacks are not related to a physical disorder. The symptoms reach maximum intensity in 10 min. At least four of the symptoms listed below must be present, one of which MUST be from items (a) to (d):

1. palpitations, a pounding heart, or an accelerated heart rate,
2. sweating,
3. trembling or shaking,
4. a dry mouth,
5. difficulty in breathing,
6. a feeling of choking,
7. chest pain or discomfort,
8. nausea or abdominal distress,
9. feeling dizzy, unsteady, faint, or light-headed,
10. feelings of derealization or depersonalization,
11. fear of losing control, "going crazy" or passing out,
12. fear of dying,
13. hot flushes or cold chills and
14. numbness or tingling sensations.

Panic disorder is associated with a relatively chronic course and a high risk of relapse for those individuals whose symptoms do remit. Cognitions during panic attacks play an important role in the patient's levels of fear and anxiety. Both pharmacological and cognitive behavioural therapies are more effective than placebo or control treatment. The combination of antidepressants with exposure in vivo is superior to other therapies for the short-term treatment of patients with panic disorder with agoraphobic avoidance.

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