About Panic Disorder
What is Panic Disorder? What is its prevalence? How can I tell if my patient is affected by panic?
Before understanding and diagnosing panic we recommend a review of
the Diagnostic and Statistical Manual (DSM-IV), the official
classification system of the American Psychiatric Association. The
DSM-IV identifies the following primary types of anxiety disorder:
1. Specific Phobias: characterized by intense fear
of specific circumstances or objects which pose no real danger to the
patient. Specific phobias are common among young children. These
phobias tend to disappear, as children grow older.
2. Social phobia: characterized by marked,
persistent fear of performance situations in which the person is
exposed to unfamiliar people or scrutiny. The individual fears acting
in a humiliating or embarrassing manner.
3. Panic disorder: characterized by recurrent
spontaneous episodes associated with physiological and psychological
symptoms (APA, 1994). Panic disorder often occurs with agoraphobia, a
condition characterized by fear of certain places or situations where
the person might not be able to get help or escape in the event of a
panic attack.
4. Agoraphobia: a condition characterized by fear
of certain places or situations where the person might not be able to
get help or escape in the event of a panic attack. Agoraphobia
sometimes occurs without a history of panic disorder.
5. Generalized anxiety disorder (GAD): characterized
by excessive or unrealistic worry over a variety of issues. The
intensity, duration or frequency of the anxiety and worry is far out of
proportion to the actual likelihood or impact of the feared event.
6. Obsessive compulsive disorder (OCD):
characterized by persistent and recurring thoughts or "obsessions" that
consume the individual for more than one hour per day and generally
involve anxiety or fears. Many people with OCD feel compelled to
perform repetitive behaviors known as "compulsions" to relieve the
anxiety caused by their obsessions.
7. Post-traumatic stress disorder (PTSD): characterized
by the re-experiencing of a traumatic event. The person's response to
the trauma involves intense fear, helplessness, or horror.
8. Acute stress disorder: characterized by symptoms
similar to those of post-traumatic stress disorder but the symptoms
have been present for less than 4 weeks following the traumatic event.
The DSM-IV system also identifies the following as potential diagnoses:
1) Anxiety disorder due to a general medical condition;
2) substance-induced anxiety disorder, and;
3) anxiety disorder not otherwise specified.
In North America anxiety disorders are among the most prevalent of
all psychiatric illnesses. The lifetime prevalence for all categories
of anxiety disorders in the United States is 19.2%.