Dsm 5 panic attack

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DSM-5 Panic Attack: Key Changes and Implications

Introduction to DSM-5 Panic Attack Criteria

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), introduced several significant changes to the classification and diagnosis of panic attacks (PAs) and panic disorder (PD). These changes reflect a shift towards a more dimensional approach in psychiatric nosology, aiming to improve diagnostic accuracy and treatment outcomes 24.

Separation of Panic Disorder and Agoraphobia

One of the most notable changes in DSM-5 is the separation of panic disorder and agoraphobia into distinct diagnoses. Previously, these conditions were often diagnosed together, but DSM-5 now requires clinicians to diagnose them separately, which helps in providing more targeted treatment 24. Additionally, agoraphobia now has a 6-month duration requirement, distinguishing it further from specific phobias .

Panic Attacks as a Specifier

DSM-5 allows panic attacks to be used as a specifier for any mental disorder, not just panic disorder. This means that panic attacks can be noted as a significant symptom in various psychiatric conditions, such as major depressive disorder or social anxiety disorder, providing a more comprehensive understanding of a patient's mental health 25. This change underscores the importance of recognizing panic attacks across different contexts, as they can significantly impact the severity and course of various mental disorders .

Symptomatology and Subtypes of Panic Attacks

Panic attacks are characterized by sudden episodes of intense fear or discomfort, accompanied by physical and cognitive symptoms such as palpitations, sweating, trembling, shortness of breath, and fear of losing control or dying . Research has identified different subtypes of panic attacks, including respiratory, nocturnal, nonfearful, cognitive, and vestibular, although these subtypes have not yet been validated for clinical utility . The symptom structure of panic attacks often includes dizziness-related symptoms, cardiorespiratory distress, and cognitive factors, highlighting the heterogeneous nature of the condition .

Clinical Implications and Treatment

The changes in DSM-5 have significant clinical implications. By recognizing panic attacks as a specifier, clinicians can better assess the severity and prognosis of various mental disorders, leading to more personalized treatment plans . The separation of panic disorder and agoraphobia allows for more precise interventions, potentially improving treatment outcomes and reducing the economic burden associated with these conditions .

Conclusion

The DSM-5 revisions for panic attacks and panic disorder represent a critical step towards a more nuanced understanding of these conditions. By separating panic disorder and agoraphobia and recognizing panic attacks as a specifier across all mental disorders, DSM-5 enhances diagnostic precision and treatment efficacy. Ongoing research is essential to further validate these changes and explore the potential for subtyping panic attacks to improve clinical outcomes.

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Most relevant research papers on this topic

Cross‐national epidemiology of panic disorder and panic attacks in the world mental health surveys

The scarcity of cross‐national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM‐5) regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population.

Rigorous JournalHighly Cited

2016·

149citations

·P. de Jonge et al.

PANIC DISORDER AND AGORAPHOBIA: AN OVERVIEW AND COMMENTARY ON DSM‐5 CHANGES

The DSM-5 changes for panic disorder and agoraphobia may improve access to evidence-based treatment, but some changes may be questionable and require further research for validation.

2014·

60citations

·G. Asmundson et al.

Panic attacks as a dimension of psychopathology: evidence for associations with onset and course of mental disorders and level of functioning.

Panic attacks outside of panic disorder are associated with increased prevalence, onset, persistence, and impaired functioning, suggesting their inclusion as a separate dimension in the DSM-5.

Observational Study

2012·

31citations

·N. Batelaan et al.

Panic Disorder: Current Research and Management Approaches

Panic disorder research focuses on a bio-psychosocial-behavioral treatment model that integrates behavioral, physiological, neurobiological, and genetic data to better understand and manage the disorder.

Very Rigorous Journal

2019·

11citations

·Yong-Ku Kim

Panic Disorder and Panic Attacks

Panic attacks and Panic Disorder are distinct anxiety disorders, with Panic Disorder characterized by recurrent, unexpected attacks and a history of anxiety-related symptoms.

2018·

5citations

·P. Jonge et al.

A comparison of the nature and correlates of panic attacks in the context of Panic Disorder and Social Anxiety Disorder

Panic attacks in Panic Disorder are more severe than those in social anxiety, possibly driven by cognitive disturbances during attacks.

Observational StudyRigorous Journal

2016·

14citations

·L. Brown et al.

Examining the Panic Attack Specifier in Social Anxiety Disorder

The presence of the panic attack specifier in social anxiety disorder does not increase comorbidity or severity of social anxiety.

Observational Study

2016·

3citations

·Nicholas P. Allan et al.

The symptom structure of panic attacks.

Panic attacks are characterized by a three-factor model: dizziness-related symptoms, cardiorespiratory distress, and cognitive factors, with helplessness and thoughts of escape being the highest severity factors.

Observational StudyHighly Cited

1994·

77citations

·B. Cox et al.

Subtypes of panic attacks: a critical review of the empirical literature

Panic attack subtypes currently lack sufficient and reliable external validation criteria to indicate functional differences, but further research may support their future designation and clinical utility.

Literature Review

2009·

65citations

·K. Kircanski et al.

Panic disorder: a review of DSM‐IV panic disorder and proposals for DSM‐V

Slight changes are proposed for DSM-V panic disorder criteria to improve differentiation between panic and surrounding anxiety, while maintaining the developmental expression of panic attacks and panic disorder.

Literature ReviewHighly Cited

2010·

135citations

·M. Craske et al.

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