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Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun.

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Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet].

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Table 3.10Panic Disorder and Agoraphobia Criteria Changes from DSM-IV to DSM-5

DSM-IV DisorderDSM-IV CriteriaDSM-5 DisorderDSM-5 Criteria
Diagnostic Class: Anxiety DisordersSAME
Panic Attack1A 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 Attack1An 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.
  • List is unchanged, except that “hot flushes” has been modified to “heat sensations” and there has been a reordering of symptoms.
Agoraphobia1Anxiety 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.AgoraphobiaA 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.
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/AThe agoraphobic situations almost always provoke fear or anxiety.
N/AThe fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context.
N/AThe fear, anxiety, or avoidance is persistent, typically lasting 6 months or more.
N/AThe 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 DisorderThe presence of agoraphobia related to fear of developing panic-like symptoms.AgoraphobiaThe 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 conditionDROPPED
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 AgoraphobiaBoth:
  • Recurrent and unexpected panic attacks (see below)
  • ≥1 attack has been followed by 1 month or more of 1 or more of the following
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 DisorderBoth:
  • Recurrent and unexpected panic attacks (see below)
  • ≥1 attack has been followed by 1 month or more of 1 or both of the following
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 conditionSAME
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 agoraphobiaDROPPED
1

Not a codable disorder, considered a feature of the specific disorder in which the panic attack/agoraphobia occurs.

From: 3, Mental Illness

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