Alerts and Notices
SynopsisPanic disorder is characterized by spontaneous panic attacks, which are periods of intense fear that typically peak within 10 minutes and last 20-30 minutes. Attacks have no discernable trigger. Symptoms develop abruptly and include palpitations, sweating, trembling, sense of shortness of breath or choking, chest pain, nausea, dizziness, and lightheadedness. Patients often describe feelings of detachment, loss of control, impending doom, and/or a fear of dying. Mental status examination is typically normal. Patients often present in the emergency room with cardiac or pulmonary concerns from somatic symptoms.
Episodes are recurrent, and fear of attacks leads to significant behavioral changes, such as avoidance of specific situations or locations and/or personality changes. Other symptoms experienced in between attacks include headache, diarrhea, insomnia, fatigue, and ruminations.
Panic disorder is a common psychiatric disorder that demonstrates significant heredity. Women are more likely to be affected than men. The average age of onset is 24 years, with most patients developing the condition between the ages of 18 and 45 years. Over 80% of patients have another psychiatric disorder, most often a mood disorder, such as depression, or substance use disorder. Common comorbid medical conditions include chronic obstructive pulmonary disease (COPD), irritable bowel syndrome, migraines, restless legs syndrome, and asthma. Patients are also at increased risk for suicide.
Patients with this disorder may have an increased risk of various general medical conditions.
F41.0 – Panic disorder [episodic paroxysmal anxiety]
371631005 – Panic disorder
Differential Diagnosis & PitfallsMedical conditions that may mimic panic attacks include:
- Acute coronary syndrome
- Coronary artery disease
- Myocardial infarction
- Cardiac arrhythmias, such as atrial fibrillation
- Pulmonary embolus
- Transient ischemic attack
- Seizure disorder (see seizure)
- Anxiety disorder
- Substance use disorders
- Phobias, including agoraphobia
- Bipolar disorder
- Posttraumatic stress disorder
- Somatic symptom and related disorders