PANIC DISORDER

Course overview

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. FOUR OR MORE OF A SPECIFIC SET OF PHYSICAL SYMPTOMS ACCOMPANY A PANIC ATTACK. PANIC ATTACKS OCCUR AS OFTEN AS SEVERAL TIMES PER DAY OR AS INFREQUENT AS ONLY A FEW ATTACKS PER YEAR. A HALLMARK FEATURE OF PANIC DISORDER IS THAT ATTACKS OCCUR WITHOUT WARNING. THERE IS OFTEN NOT A SPECIFIC TRIGGER FOR THE PANIC ATTACK. PATIENTS SUFFERING FROM THESE ATTACKS SELF-PERCEIVE A LACK OF CONTROL. PANIC ATTACKS, HOWEVER, ARE NOT LIMITED TO PANIC DISORDER. THEY CAN OCCUR ALONGSIDE OTHER ANXIETY, MOOD, PSYCHOTIC, SUBSTANCE USE, AND EVEN MEDICAL DISORDERS. PANIC ATTACKS CAN BE ASSOCIATED WITH INCREASED SYMPTOM SEVERITY OF VARIOUS DISORDERS, SUICIDAL IDEATION AND BEHAVIOR, AND DIMINISHED TREATMENT RESPONSE IN PATIENTS WITH CONCOMITANT ANXIETY AND MENTAL DISORDERS. MAKING AN ACCURATE DIAGNOSIS OF PANIC DISORDER IS NOT POSSIBLE WITHOUT A THOROUGH AWARENESS OF WHAT CONSTITUTES PANIC ATTACKS. IT IS IMPORTANT TO DIFFERENTIATE SYMPTOMS EXPERIENCED DURING OR IN ASSOCIATION WITH AN ACTUAL ALARM SITUATION, SUCH AS A PHYSICAL THREAT, FROM A TRUE PANIC ATTACK. ACCORDING TO DSM V (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. ALTHOUGH PANIC ATTACKS MAY ORIGINATE FROM THE DIRECT EFFECTS OF SUBSTANCE USE, MEDICATIONS, OR A GENERAL MEDICAL CONDITION LIKE HYPERTHYROIDISM OR VESTIBULAR DYSFUNCTION, THEY MUST NOT DERIVE SOLELY FROM THESE. FOR PATIENTS WITH PANIC DISORDER, THE FEAR AND ANXIETY SYMPTOMS THAT THEY EXPERIENCE PRIMARILY MANIFEST THEMSELVES IN A PHYSICAL MANNER AS OPPOSED TO A COGNITIVE ONE. THIS IS A DISTINCTIVE FINDING. THIS ACTIVITY REVIEWS PANIC DISORDER AND THE ROLE OF THE INTERPROFESSIONAL TEAM IN THE RECOGNITION AND MANAGEMENT OF THIS CONDITION.