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panic disorder diagnosis dsm

Panic disorder is classified as an anxiety disorder in DSM-IV. For panic disorder to be present, unexpected panic attacks must occur. Panic attacks are defined as ‘a discrete period of intense fear and discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes (DSM-IV, APA 1994: 432): palpitations, pounding heart or accelerated heartrate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, light-headed or faint; derealization (feelings of unreality) or depersonalization (being detached from oneself); fear of losing control or going crazy; fear of dying; paraesthsias; and chills or hot flushes.

In diagnosing panic disorder, Criterion A states that both panic attacks must occur and at least one of the attacks has been followed by one month (or more) of one (or more) of either persistent concern about additional attacks, and/or worry about the implications of the attack or its consequences (for example, losing control, having a heart attack, ‘going crazy’) and/or a significant change in behaviour related to the attacks. Criterion B relates to the presence or absence of agoraphobia (see above) and determines whether the problem is classified as panic disorder with agoraphobia or panic disorder without agoraphobia.

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