Summary
Definition
History and exam
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
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
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
Diagnostic investigations
1st investigations to order
- avaliação clínica
Investigations to consider
- eletrocardiograma (ECG)
- glicose sanguínea
- testes da função tireoidiana
- perfil metabólico
- análise toxicológica
Treatment algorithm
ataque de pânico agudo
transtorno de pânico
ataques de pânico sem transtorno de pânico
Contributors
Authors
Craig N. Sawchuk, PhD

Professor
Department of Psychiatry and Psychology
Mayo Clinic
Rochester
MN
Disclosures
CNS declares that he has no competing interests.
Jason P. Veitengruber, MD

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
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.
References
Key articles
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.Full text
Penninx BW, Pine DS, Holmes EA, et al. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-27.Full text Abstract
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.Full text Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Agorafobia
- Fobias específicas
- Transtorno da ansiedade social
More DifferentialsGuidelines
- Diagnostic and statistical manual of mental disorders: 5th edition, text revision (DSM-5-TR)
- Generalised anxiety disorder and panic disorder in adults: management
More GuidelinesPatient information
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