Anxiety- Panic disorder

Question 1

Definition of panic disorder

Answer 1

ICD10 - reccurent attacks of SEVERE anxiety-which arent restricted to any particular situations/circumstances
several within a month
In between episodes-fine and minial anxiety
panic disorder should not be the main diagnosis if depressive disorder exist at the same time as attacks start

Question 2

Sx of panic disorder

Answer 2

classically described as 100% anxiety with physical sx
suddent onset/out of the blue/ last <30mins
alarming thoughts (gonna die) can provoke further panic until reassured or safety behaviours (call ambulance, take medication, etc)

usually anxiety attack sx
Palps, tachy, chest tight, choking, pins and needs, shaking, dizzy, sweat, depersonalisation

Question 3

Mx of panic disorder

Answer 3

Education, reasurance and self help
1=low intensity psycho
Self help (individual, guided OR non guided)- 6 weeks (+/- therpay appointements)

2= High intensity psych +/- medication
individual CBT, etc
1st line - CBT + SSRI (citalopram)
2nd (after 12w not improving)- TCA (imipramide) or add BDZ (max 2-4w)

3= refer to pysch

65% achieve complete remission
10% continue to have significant sx