Mental health articles

panic disorder symptoms and Clinical Features
Epidemiology.One of the original epidemiological studies found that agoraphobia occurs in 0.6% of the population. More recently, the National Comorbidity Survey reported a lifetime prevalence of 3.5%. The reason for the discrepancy between these studies is more likely attributable to the interviewing techniques and criteria than to any increase in the prevalence of agoraphobia. Though panic disorder is less prevalent than several other anxiety disorders, it is the most common anxiety disorder presenting to anxiety disorder clinics and is one of the most common disorders in any outpatient facility. This is an indication of the tremendous distress and interference that panic attacks can cause in an individual’s life.
Sex Distribution.By far, the majority of panic disorder sufferers are female. This ratio varies, however, depending on the degree of avoidance. Subjects with more extensive avoidance comprise a higher proportion of females (around 75% to 90%), whereas subjects with less avoidance comprise a slightly lower proportion of females. The reasons for this sex difference are not clear but may reflect either a real difference in fear levels or a difference in reporting and presentation that is attributable to cultural influences. Onset.Panic attacks most commonly begin around the middle to late 20s. In most cases, the onset is sudden and unexpected, and most individuals can clearly recall their first panic attack. Despite the fact that most patients will report that the panic attacks are different from anything they have experienced before, several studies show that many patients may have a somewhat somatic or even hypochondriacal focus before their panic attacks begin. Cognitive Symptoms.Panic disorder is characterized by a specific type of cognitive focus. Specifically, a number of studies demonstrated that panic disorder cognitions center around thoughts of dramatic and immediate threats such as death or insanity. For example, Hibbert found that compared to individuals with GAD, subjects with panic disorder were more likely to experience thoughts related to physical, psychological, or social disaster. Similarly, some studies showed that people with panic disorder are more likely than others to interpret ambiguous situations as indicating physical danger. Somatic Symptoms.As mentioned before, panic disorder patients are very somatically focused and typically report a large number of somatic symptoms. In fact, studies f ind that panic disorder subjects report more somatic symptoms than subjects with almost any other anxiety disorder. When the specific patterns of symptoms are compared, it has been found that panic disorder subjects report more symptoms related to the respiratory and cardiovascular systems during their panic attacks than GAD patients during their high levels of anxiety. Most studies have found no differences in the somatic symptoms, nor the frequency of panic attacks, between extensive and minimal avoiders.
Interestingly, some studies demonstrated a relationship between cognitive and somatic symptoms in panic disorder such that certain types of somatic symptoms were more likely to be found together with specific cognitive symptoms (e.g., palpitations, chest pain, and thoughts of a heart attack. Behavioral Features.Typically, panic disorder is associated with avoidance of a large number of external situations, although there is large individual variation in the extent of avoidance. Some commonly avoided situations include shopping malls, driving, theaters, being alone, and going far from home. Although it has often been assumed that individuals diagnosed with panic disorder without agoraphobia do not avoid; clinical observation in fact suggests that these individuals avoid a large number of subtle situations that produce somatic sensations (e.g., saunas, aerobic exercise, or inflating balloons).

Tags: disorder, panic, symptoms