Panic Disorder Diagnosis

Diagnosis of panic disorder can be difficult because several other physical and mental disorders are associated with panic attacks. You will need a thorough physical and mental evaluation before a proper diagnosis can be made. Diagnosis of panic attack is based on a proper evaluation and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders(DSM-IV).

In the DSM-IV, panic disorder is defined as recurrent, unexpected panic attacks followed by at least one month of persistent concern about having another attack, worry about the consequences of panic attacks, and a change in behavior as a result of the attacks.

Your doctor will conduct an evaluation that may include the following:

Initial Assessment

Your doctor will ask about the following:

• Your medical history
• Symptoms you experience during an attack
• How long you have been having the attacks
• When the attacks started
• How often they occur
• When and where they tend to occur
• How long they last
• What effect they have on your ability to function

Evaluation of Medical Disorders

Your doctor will also look for and rule out medical disorders that could cause your symptoms. Medical conditions commonly associated with panic disorder include:

• Hyperthyroidism
• Cardiac arrhythmias
• Mitral valve prolapse
• Cushing’s syndrome
• Carcinoid syndrome
• Parkinson’s disease treated with levodopa
• Heart attack
• Pulmonary embolism
• Episodic hypoglycemia
• Mastocytosis
• Pheochromocytoma

Your doctor should also ask about your intake of:

• Medications
• Foods
• Herbs and supplements

Evaluation for Substance Abuse

Use or withdrawal from addictive substances can cause symptoms of panic. Substances that can cause symptoms of panic include stimulants, such as cocaine and caffeine. Your doctor may also ask about your use of alcohol , nicotine , addictive medications (particularly sedatives), illegal drugs , and other substances.

Evaluation of Other Psychiatric Disorders

Depression , generalized anxiety disorder , social phobia , substance abuse, and personality disorders often occur with panic disorder. You may be evaluated for these and other disorders.

• Screening for Panic Disorder

References:

Alloy L, Acocella J, Jacobsen N. Abnormal Psychology. 8th ed. Boston, MA: McGraw-Hill; 2000.

Panic disorder. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/panic-disorder/index.shtml .

Moore DP, Jefferson JW. Handbook of Medical Psychiatry.2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.