Panic Disorder: Current Research and Management Approaches

Panic disorder is one of the most common anxiety disorders, with lifetime prevalence rates in the general population reported between 2.1-4.7%. Panic disorder is typically associated with a chronic progression, which results in economic burden and a loss of quality of life, therefore, proper prevention and treatment of panic disorder is important. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was revised to accommodate a paradigm shift from a categorical to a dimensional approach in psychiatric nosology and taxonomy. However, the categorical concept of panic disorder still remains in the DSM-5. An overview of the changes to diagnostic criteria for panic disorder from the DSM-IV to DSM-5 are as follows: 1) distinction of agoraphobia from panic disorder and 2) defining panic attacks as a specifier. In the DSM-5, a panic disorder diagnosis is operationally defined as the fulfillment of both recurrent unexpected panic attacks (Criterion A) and the existence of one or more of the following persistent panic attack related conditions for at least one month: concern, worry, and behavioral change (Criterion B). Panic disorder has been modeled in terms of the negative valence systems domain in the Research Domain Criteria initiative. 3 A panic attack (Criteria A) can be conceptualized as a prototypical expression of a fear response to an acute internal threat stimulus, while concerns and worries about the consequences of panic attacks (Criteria B) can be conceptualized as responses to potential harm within the negative valence system.