Panic Attack
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Basics
Description
- Characteristic, acute episodes of physical symptoms and intense fear that rapidly peak within 10 min and resolve in ∼20 min
- There may be a nonfearful variant in medical patients
Panic Disorder
- Recurrent, unexpected panic attacks with ≥1 mo of persistence:
- Concerns about having another attack
- Worry about the implications or consequences of the attacks
- Behavioral change, such as phobic avoidance, related to the attacks
- Agoraphobia = anxiety related to being in places where escape is difficult
- Episodic, recurrent, or chronic attacks
- Frequently comorbid with depression, substance abuse, disability, suicidal tendency
Genetics
- Probably genetic
- Family history of panic or anxiety is common
- Altered serotonin- and benzodiazepine-receptor function
Etiology
Mechanism
Limbic system, norepinephrine release, other neurotransmitters (e.g., serotonin) implicated, leading to “fight-or-flight” response
Risk Factors
- Major life events in the year preceding onset
- Family history of panic or anxiety
- Childhood shyness or separation anxiety
- May develop in the course of predisposing physical illness or cocaine abuse:
- May persist after the illness or substance use has resolved
- Twice as common in women
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Characteristic, acute episodes of physical symptoms and intense fear that rapidly peak within 10 min and resolve in ∼20 min
- There may be a nonfearful variant in medical patients
Panic Disorder
- Recurrent, unexpected panic attacks with ≥1 mo of persistence:
- Concerns about having another attack
- Worry about the implications or consequences of the attacks
- Behavioral change, such as phobic avoidance, related to the attacks
- Agoraphobia = anxiety related to being in places where escape is difficult
- Episodic, recurrent, or chronic attacks
- Frequently comorbid with depression, substance abuse, disability, suicidal tendency
Genetics
- Probably genetic
- Family history of panic or anxiety is common
- Altered serotonin- and benzodiazepine-receptor function
Etiology
Mechanism
Limbic system, norepinephrine release, other neurotransmitters (e.g., serotonin) implicated, leading to “fight-or-flight” response
Risk Factors
- Major life events in the year preceding onset
- Family history of panic or anxiety
- Childhood shyness or separation anxiety
- May develop in the course of predisposing physical illness or cocaine abuse:
- May persist after the illness or substance use has resolved
- Twice as common in women
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