Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • unexpected onset
  • apprehension and worry
  • behavioural avoidance
  • tachycardia
  • positive PRIME-MD panic screen
  • Panic Disorder Severity Scale (PDSS)
  • GAD-7 cute score ≥10

Other diagnostic factors

  • palpitations; chest pain and discomfort
  • nausea and abdominal pain
  • dizziness
  • perceptual abnormality
  • respiratory symptoms
  • reliance on safety cues
  • paraesthesias
  • muscle shaking
  • sweating
  • fainting
  • chills or hot flushes

Risk factors

  • hx in first-degree relatives
  • age 20 to 30 years
  • female gender
  • white ethnicity
  • major life events
  • comorbid disorders
  • psychological factors
  • asthma and respiratory variability
  • cigarette smoking and caffeine use
  • cardiac abnormalities

Diagnostic investigations

Investigations to consider

  • ECG
  • blood glucose
  • TFTs
  • toxicology screen
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Craig N. Sawchuk

Associate Professor

Department of Psychiatry and Psychology

Mayo Clinic

Rochester

MN

Disclosures

CNS declares that he has no competing interests.

Jason P. Veitengruber

Associate Professor

Department of Psychiatry and Behavioral Sciences

University of Washington School of Medicine

Seattle

WA

Disclosures

JPV declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant Psychiatrist

Leeds and York Partnership NHS Foundation Trust

Bootham Park Hospital

York

UK

Disclosures

PB declares that he has no competing interests.

Professor

Clinical Training Program

Department of Psychology

University of Arkansas

Fayetteville

AR

Disclosures

JML declares that he has no competing interests.

Professor of Psychopharmacology

Warneford Hospital

Oxford

UK

Disclosures

PJC declares that he has no competing interests.

Professor and Chair

Department of Psychiatry and Cognitive-Behavioral Medicine

Graduate School of Medical Sciences

Nagoya City University

Nagoya

Japan

Disclosures

TAF has received research funds and speaking fees from Astellas, Dai-Nippon, Sumitomo, Eli Lilly, GlaxoSmithKline, Janssen, Meiji, Otsuka, Schering-Plough, and Yoshitomi. He was on a research advisory board for Meiji and Mochida, and is currently on research advisory boards for Sekisui chemicals and Takeda Science Foundation. He has received royalties from Igaku-Shion and Seiwa-Shoten Publishers. The Japanese Ministry of Education, Science, and Technology and the Japanese Ministry of Health, Labor, and Welfare have also funded his research.

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