Diagnostic Class: Anxiety Disorders | SAME |
Panic Attack1 | A discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes Palpitations, pounding heart, or accelerated heart rate 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, lightheaded, or faint Derealization (feelings of unreality) or depersonalization (being detached from oneself) Fear of losing control or “going crazy” Fear of dying Paresthesias (numbness or tingling sensation) Chills or hot flushes.
| Panic Attack1 | An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four or more of the following symptoms occur. |
Agoraphobia1 | Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed panic attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile. | Agoraphobia | A marked fear or anxiety about two (or more) of the following five situations: Using public transportation Being in open spaces Being in enclosed spaces (e.g., shops, theaters, cinemas) Standing in line or being in a crowd Being outside the home alone.
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The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a panic attack or panic-like symptoms, or require the presence of a companion. | SAME |
N/A | The agoraphobic situations almost always provoke fear or anxiety. |
N/A | The fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context. |
N/A | The fear, anxiety, or avoidance is persistent, typically lasting 6 months or more. |
N/A | The fear, anxiety, or avoidance causes clinically significant distress or impairment in important areas of functioning. |
The anxiety or phobic avoidance is not better accounted for by another mental disorder. | SAME |
Agoraphobia without history of Panic Disorder | The presence of agoraphobia related to fear of developing panic-like symptoms. | Agoraphobia | The individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms. |
Criteria for panic disorder have never been met. | DROPPED |
The disturbance not due to the direct physiological effects of a substance (e.g., a drug of abuse or a medication) or a general medical condition | DROPPED |
If an associated general medical condition is present, the fear described in Criterion A is clearly in excess of that usually associated with the condition. | SAME |
Panic Disorder, with/without Agoraphobia | Both: Persistent concern about additional attacks Worry about the implications of the attack or its consequences A significant change in behavior related to the attacks | Panic Disorder | Both: Persistent concern about additional attacks or their consequences A significant maladaptive change in behavior related to the attacks |
The panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse or a medication) or a general medical condition | SAME |
The panic attacks are not better accounted for by another mental disorder. | SAME |
Without agoraphobia: Absence of agoraphobia (see below) | DROPPED |
With agoraphobia: Presence of agoraphobia | DROPPED |