Panic disorderPsychopathology of panic disorder
Section snippets
Types of panic attack
Panic disorder is characterized by recurrent, unexpected panic attacks.9 Full-blown attacks are defined by four or more of the symptoms in Table 1, whereas limited-symptom attacks are defined by three or fewer symptoms. The frequency and severity of panic attacks vary widely among patients. Table 2 describes the three types of panic attacks found in panic disorder (and, less commonly, in other anxiety disorders). Such panic attacks can also occur in the general population; these are often
Prevalence
Estimates of the lifetime prevalence of panic disorder range between 1% and 4.7%.9, 11 Women are diagnosed with the disorder twice as often as men.11 Panic disorder has been identified across many different cultures, although the expression of the disorder may vary from culture to culture (e.g. people with panic disorder in some cultures may be more likely to emphasize the somatic symptoms of their panic attacks, while being reluctant to report cognitive symptoms such as fears of going mad or
Aetiology
The precise aetiology of panic disorder is unknown. However, accumulated evidence supports the view that panic attacks arise from, or are worsened by, the catastrophic misinterpretation of bodily sensations. This premise is found in various theories of panic disorder, including cognitive approaches, in contemporary psychodynamic formulations and in Gorman’s neuroanatomical model of panic.
Cognitive models
Vicious circle of panic: Clark14 proposed that panic attacks arise from a tendency to catastrophically
Conclusion
Panic disorder is a common and disabling condition that tends to follow a chronic course if left untreated. It arises from multiple pathogenic processes, and recent research has led to a better understanding of the underlying mechanisms. Particular cognitive, biological and psychodynamic approaches are promising for understanding this disorder, and each approach has led to useful treatments. However, much remains to be learned about the genesis, expression and course of panic disorder.
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2012, International Journal of Social Psychiatry