Panic disorder. definition and diagnostic criteria

Panic Disorder is distinguished from simply experiencing a single panic attack.

It is a condition characterized by the recurrent and unexpected occurrence of panic attacks, accompanied by persistent worry about future attacks or their consequences, leading to significant changes in behavior.

Definition and Essential Components

The main feature of Panic Disorder is the presence of recurrent panic attacks that arise spontaneously; that is, they are not necessarily linked to a specific feared situation (although expected attacks can also occur).

In addition to the attacks themselves, it is crucial for the diagnosis that the person develops at least one of the following for a month or more after an attack:

• Persistent worry or unease about having additional panic attacks or about the implications of the attacks (e.g., fear of losing control, having a heart attack, "going crazy").

• A significant, maladaptive change in behavior related to the attacks, such as avoidance of situations where an attack is feared likely to occur or where escape or help would be difficult (which may lead to the development of agoraphobia).

Diagnostic Criteria (Based on DSM-5)

According to DSM-5, for a diagnosis of Panic Disorder:

• The panic attacks must not be attributable to the direct physiological effects of a substance (e.g., a drug of abuse or medication) or to another medical condition (e.g., overactive thyroid, cardiopulmonary disorders).

• The panic attacks are not better explained by another mental disorder. For example, whether attacks occur only in response to feared social situations (as in social phobia), specific phobic objects or situations, obsessions (as in OCD), reminders of traumatic events (as in PTSD), or separation from attachment figures.

Anticipatory worry about future attacks (the "fear of the fear") and maladaptive behavioral changes are core elements that differentiate the disorder from isolated attacks.

Impact and Course

Panic Disorder can be very disabling, as the constant fear of experiencing another attack can lead to significant restriction of activities and a decreased quality of life.

It often coexists with other anxiety disorders, especially agoraphobia.

It is a treatable disorder, with cognitive-behavioral therapy, and in some cases, medication, beingthe approaches to choice.