eMedicine Specialties > Psychiatry > Adult
Panic Disorder: Differential Diagnoses & Workup
Updated: Jul 29, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Other Problems to Be Considered
Acute stress/posttraumatic stress disorder
Adrenal dysfunction
Alcohol/sedative-hypnotic withdrawal
Drug intoxication
Generalized anxiety disorder
Hyperthyroidism
Pulmonary disease
Temporal lobe seizure activity
Vestibular dysfunction
Workup
Laboratory Studies
No laboratory parameters are specific for panic disorder. Laboratory evaluation is performed to exclude any of the aforementioned differential diagnoses.
Imaging Studies
No imaging study findings are currently specific for panic disorder, although they are performed to evaluate anatomic evidence of other diagnostic possibilities. Studies may include an EEG to exclude partial complex seizures. Investigational functional neuroimaging is not used in routine clinical practice for diagnosis or for monitoring treatment response.
Procedures
No invasive procedures are required to diagnose panic disorder, although they may be useful in eliminating other differential diagnoses. History, collateral information, and physical/Mental Status Examinations remain the diagnostic cornerstones.
More on Panic Disorder |
| Overview: Panic Disorder |
Differential Diagnoses & Workup: Panic Disorder |
| Treatment & Medication: Panic Disorder |
| Follow-up: Panic Disorder |
| References |
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References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Press; 2000.
Croom KF, Perry CM, Plosker GL. Mirtazapine: a review of its use in major depression and other psychiatric disorders. CNS Drugs. 2009;23(5):427-52. [Medline].
American Psychiatric Association. Practice guideline for the treatment of patients with panic disorder. Work Group on Panic Disorder. American Psychiatric Association. Am J Psychiatry. May 1998;155(5 Suppl):1-34. [Medline].
Bandelow B, Behnke K, Lenoir S, et al. Sertraline versus paroxetine in the treatment of panic disorder: an acute, double-blind noninferiority comparison. J Clin Psychiatry. Mar 2004;65(3):405-13. [Medline].
Bohni MK, Spindler H, Arendt M, Hougaard E, Rosenberg NK. A randomized study of massed three-week cognitive behavioural therapy schedule for panic disorder. Acta Psychiatr Scand. Mar 10 2009;[Medline].
Fogel BS, Schiffer RB, Rao SM, eds. Neuropsychiatry. ed. Baltimore, Md: Williams & Wilkins; 1996:263-8.
Hales RE, Yudofsky SC, Talbott JA, eds. APA Textbook of Psychiatry. 3rd ed. Washington, DC: American Psychiatric Press; 1999.
Kaplan HI, Sadock BJ, eds. Synopsis of Psychiatry. Behavioral Sciences/Clinical Psychiatry. 8th ed. Baltimore, Md: Williams & Wilkins; 1997:594-603.
Kim YW, Lee SH, Choi TK, Suh SY, Kim B, Kim CM, et al. Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depress Anxiety. 2009;26(7):601-6. [Medline].
Kushner MG, Sletten S, Donahue C, Thuras P, Maurer E, Schneider A, et al. Cognitive-behavioral therapy for panic disorder in patients being treated for alcohol dependence: Moderating effects of alcohol outcome expectancies. Addict Behav. Jun-Jul 2009;34(6-7):554-60. [Medline].
Marcks BA, Weisberg RB, Keller MB. Psychiatric treatment received by primary care patients with panic disorder with and without agoraphobia. Psychiatr Serv. Jun 2009;60(6):823-30. [Medline].
Pfeiffer PN, Ganoczy D, Ilgen M, Zivin K, Valenstein M. Comorbid anxiety as a suicide risk factor among depressed veterans. Depress Anxiety. Jun 18 2009;[Medline].
Pollack MH, Simon NM, Worthington JJ, et al. Combined paroxetine and clonazepam treatment strategies compared to paroxetine monotherapy for panic disorder. J Psychopharmacol. Sep 2003;17(3):276-82. [Medline].
Sadock BJ, Sadock VA, Kaplan HI. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. Baltimore, Md: Williams & Wilkins; 2000:1445-90.
Stahl SM, Gergel I, Li D. Escitalopram in the treatment of panic disorder: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. Nov 2003;64(11):1322-7. [Medline].
Stahl's Essential Psychopharmacology, Neuroscientific Basis and Practical Applications. 3rd Ed. New York: Cambridge University Press; 2008.
Swoboda H, Amering M, Windhaber J, Katschnig H. The long-term course of panic disorder--an 11 year follow-up. J Anxiety Disord. 2003;17(2):223-32. [Medline].
Further Reading
Keywords
anxiety attack, panic attack, mood disorder, agoraphobia, phobia, anxiety disorder, anxiety provocation, acute anxiety, panic, panic disorder
Differential Diagnoses & Workup: Panic Disorder