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Panic disorders

Last reviewed: 29 Jun 2025
Last updated: 14 Jul 2023

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • unexpected onset
  • apprehension and worry
  • behavioral avoidance
  • tachycardia
  • positive PRIME-MD panic screen
  • Panic Disorder Severity Scale (PDSS)
  • GAD-7 cut score ≥10
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • history in first-degree relatives
  • age 18 to 39 years
  • female sex
  • white and Native American ethnicity
  • major life events
  • comorbid disorders
  • psychological factors
  • asthma and respiratory variability
  • cigarette smoking
  • caffeine use
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical assessment
Detalhes completos

Investigações a serem consideradas

  • ECG
  • blood glucose
  • thyroid function tests
  • metabolic panel
  • toxicology screen
Detalhes completos

Algoritmo de tratamento

AGUDA

acute panic attack

CONTÍNUA

panic disorder

panic attacks without panic disorder

Colaboradores

Autores

Craig N. Sawchuk, PhD
Craig N. Sawchuk

Professor

Department of Psychiatry and Psychology

Mayo Clinic

Rochester

MN

Declarações

CNS declares that he has no competing interests.

Jason P. Veitengruber, MD
Jason P. Veitengruber

Associate Professor

Department of Psychiatry and Behavioral Sciences

University of Washington School of Medicine

Seattle

WA

Declarações

JPV declares that he has no competing interests.

Revisores

Tanveer A. Padder, MD

Chairman

Department of Psychiatry

Trinity School of Medicine

Warner Robins

GA

Declarações

TAP declares that he has no competing interests.

Paul Blenkiron, BM BCh, MA

Consultant Psychiatrist

Leeds and York Partnership NHS Foundation Trust

Bootham Park Hospital

York

UK

Declarações

PB declares that he has no competing interests.

Philip J. Cowen, MD, FRCPsych, FMedSci

Professor of Psychopharmacology

Warneford Hospital

Oxford

UK

Declarações

PJC declares that he has no competing interests.

Toshiaki A. Furukawa, MD, PhD

Professor and Chair

Department of Psychiatry and Cognitive-Behavioral Medicine

Graduate School of Medical Sciences

Nagoya City University

Nagoya

Japan

Declarações

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.

Andrews G, Bell C, Boyce P, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder. Australian & New Zealand Journal of Psychiatry. 2018;52(12):1109-172.Texto completo

Penninx BW, Pine DS, Holmes EA, et al. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-27.Texto completo  Resumo

Katzman MA, Bleau P, Blier P, et al; Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada and McGill University. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14 Suppl 1:S1.Texto completo  Resumo

Roy-Byrne P, Craske MG, Sullivan G, et al. Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. JAMA. 2010 May 19;303(19):1921-8. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Agoraphobia
    • Specific phobia
    • Social anxiety disorder
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Anxiety disorders in adults: screening
    • Diagnostic and statistical manual of mental disorders: 5th edition, text revision (DSM-5-TR)
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Panic attacks: what are they?

    Panic attacks: what treatments work?

    Mais Folhetos informativos para os pacientes
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