What is Panic Disorder? What is its prevalence? How can I tell if my patient is being 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 that pose no real danger, 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 that are associated with physiological and psychological symptoms (APA, 1994). Panic disorder often occurs along 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%.