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Transtornos de pânico

Última revisão: 18 Jun 2025
Última atualização: 14 Jul 2023

Resumo

Definição

História e exame físico

Key diagnostic factors

  • presença de fatores de risco
  • início inesperado
  • apreensão e preocupação
  • comportamento de evitação
  • taquicardia
  • resultado positivo para rastreamento do pânico da Avaliação de Transtornos Mentais na Atenção Primária (PRIME-MD)
  • escala de gravidade do transtorno de pânico (EGTP)
  • pontuação de corte do GAD-7 ≥10
Full details

Other diagnostic factors

  • palpitações, dor e desconforto torácicos
  • náuseas e dor abdominal
  • tontura
  • anormalidades das percepções
  • sintomas respiratórios
  • dependência de pistas indicativas de segurança
  • parestesias
  • tremor muscular
  • sudorese
  • desmaios
  • calafrios ou fogachos
Full details

Risk factors

  • história em parentes de primeiro grau
  • idade 18 a 39 anos
  • sexo feminino
  • etnia branca e índios norte-americanos
  • eventos vitais importantes
  • transtornos comórbidos
  • fatores psicológicos
  • asma e variabilidade respiratória
  • tabagismo
  • consumo de cafeína
Full details

Diagnostic investigations

1st investigations to order

  • avaliação clínica
Full details

Investigations to consider

  • eletrocardiograma (ECG)
  • glicose sanguínea
  • testes da função tireoidiana
  • perfil metabólico
  • análise toxicológica
Full details

Treatment algorithm

ACUTE

ataque de pânico agudo

ONGOING

transtorno de pânico

ataques de pânico sem transtorno de pânico

Contributors

Authors

Craig N. Sawchuk, PhD
Craig N. Sawchuk

Professor

Department of Psychiatry and Psychology

Mayo Clinic

Rochester

MN

Disclosures

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

Disclosures

JPV declares that he has no competing interests.

Peer reviewers

Tanveer A. Padder, MD

Chairman

Department of Psychiatry

Trinity School of Medicine

Warner Robins

GA

Disclosures

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

Disclosures

PB declares that he has no competing interests.

Philip J. Cowen, MD, FRCPsych, FMedSci

Professor of Psychopharmacology

Warneford Hospital

Oxford

UK

Disclosures

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

Раскрытие информации

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.

Список литературы

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Основные статьи

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.Полный текст

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

Katzman MA, Bleau P, Blier P, et al. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry. 2014;14 Suppl 1:S1.Полный текст  Аннотация

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. Аннотация

Статьи, указанные как источники

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