Susan L. Siegfreid Linda Meredith Nicholas
Psychiatric. .D.i..fferenti.a!..D.i.a.gn.o.s,i.s Med,i.ca!. . . Differential .Diagnosis
Panic attacks are short-lived episodes of anxiety or intense fear, accompanied by a range of somatic symptoms, which may include tachycardia, tachypnea, dyspnea, chest tightness, weakness, nausea, dizziness, and paresthesias. Panic disorder is characterized by recurrent, spontaneous panic attacks. Panic disorder may occur with or without agoraphobia, a condition typified by avoidance of places or situations associated with anxiety. Panic disorder with agoraphobia may be severely disabling, as patients may be incapable of functioning socially or occupationally.
Since many of the symptoms of panic overlap with those of acute medical illness, the first point of contact for patients with panic disorder is often the emergency department. Data from the Epidemiologic Catchment Area study found that, when compared with patients who had either other psychiatric or medical problems, patients with panic disorder had the highest rates of use of emergency room services.1 A study by Simpson and colleagues reported that this increased utilization preceded the diagnosis of panic disorder by up to 10 years.2 Therefore, it is important for emergency clinicians to understand panic disorder, its common presentations, and its treatment.
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