Panic Disorder DSM-IV Criteria

This Panic Disorder page is an abridged version of the DSM-IV Criteria.
(The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) is a guide to the diagnosis of mental disorders in the United States).

Please note: This page has been included for information purposes only - as a guideline to diagnosis- and although these criteria are displayed to provide a guideline to diagnosis they cannot substitute a visit to a doctor or mental health practitioner.

One more thing:
A "diagnosis" is merely a label.
It does not define you as a person.

Be very aware of the power of Labelling - see my pages on the need for certainty and

The Power of Words as Labels - subscribe to my RSS feed to get it as soon as it's available.

DIAGNOSTIC CRITERIA FOR A PANIC ATTACK

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

• palpitations, pounding heart, or accelerated heart rate
• sweating
• trembling or shaking
• sensations of shortness of breath or smothering
• feeling of choking
• chest pain or discomfort
• nausea or abdominal distress
• feeling dizzy, unsteady, lightheaded, or faint
• derealization (feelings of unreality) or depersonalization (being detached from oneself)
• fear of losing control or going crazy
• fear of dying
• paresthesias (numbing or tingling sensations)
• chills or hot flushes

DIAGNOSTIC CRITERIA FOR PANIC DISORDER WITHOUT AGORAPHOBIA

A. Both (1) and (2):

1. Recurrent unexpected Panic Attacks

2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

• - persistent concern about having additional attacks
• - worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
• - a significant change in behavior related to the attacks

B. Absence of Agoraphobia

C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

DIAGNOSTIC FEATURES

The essential feature of Panic Disorder is the presence of recurrent, unexpected Panic Attacks followed by at least 1 month of persistent concern about having another Panic Attack, worry about the possible implications or consequences of the Panic Attacks, or a significant behavioral change related to the attacks (Criterion A).

With Panic Disorder, the Panic Attacks are not due to the direct physiological effects of a substance (e.g., Caffeine Intoxication) or a general medical condition (e.g., hyperthyroidism) (Criterion C).

Finally, the Panic Attacks are not better accounted for by another mental disorder (e.g., Specific or Social Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, or Separation Anxiety Disorder) (Criterion B).