Panic Disorder Definition An anxiety disorder characterised by recurrent, unexpected panic attacks in addition to at least one month period of persistent worry about experiencing additional attacks or their consequences and/or maladaptive behaviour to avoid further episodes Epidemiology • • More common in females Peaks at 26 to 34 Aetiology • • Genetics -> strong association Association conditions - Agoraphobia - Substance use disorder - Comorbid mood disorders e.g. major depressive disorder, bipolar Clinical Features • • • Recurrent attacks characterised by: - Symptoms that peak within minutes - Somatic symptoms e.g. palpitations. - Cognitive symptoms e.g. fear of dying Persistent worry about future panic attacks Avoidance of triggering situations Diagnosis • • • Consider if recurrent Exclusion of organic causes: - Thyroid function tests - CBC -> rule out anaemia - ECG - Urine drug screening - BMP -> rule our electrolyte disturbance DSM-V - Diagnosis is confirmed if all of the following criteria is met. - Recurrent attacks, where at least four the following occur: ➔Tachycardia ➔Sweating shaking or trembeling - - ➔SOB ➔Chocking sensation ➔Chest pain or discomfort ➔Abdominal distress or nausea ➔Parasthesias ➔Depersonalisation or derealisation ➔Fear of losing control ➔Fear of dying At least one panic attack followed by at least one month of at least one of: ➔Persistent concern about having another panic attack or about it’s consequences such as losing control. ➔Significant maladaptive behavioural changes in response to the attacks e.g. avoiding situations in which previous attacks have occurred. Panic attacks are not attributed to: ➔ Side effects of medications, substance or a medical condition ➔Another psychiatric disorder such as phobias and social anxiety.