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Pediatric Panic Disorder Clinical Presentation

  • Author: Jeffrey S Forrest, MD; Chief Editor: Caroly Pataki, MD  more...
Updated: Dec 07, 2015


Children with panic disorder may experience the following somatic symptoms during discrete panic attacks:

  • Dyspnea and/or palpitations with or without tachycardia
  • Diaphoresis
  • Nausea and/or diarrhea
  • Urinary urgency
  • Cold and clammy hands
  • Dry mouth
  • Dysphagia or complaint of a "lump in the throat"

Patients also may have the above symptoms, to some degree, as symptoms of anticipatory anxiety or comorbid generalized anxiety disorder. Anxious muscle tension also can occur, with trembling, twitching, a feeling of shakiness, and muscle soreness or aches. Stomachaches and headaches may be the most frequent symptoms.

Diagnostic Criteria (DSM-5)

The DSM-5 criteria for panic disorder are as follows:[1]

  • Recurrent unexpected panic attacks
  • At least one of the attacks has been followed by 1 month (or more) of one or both of the following:
    • Persistent concern or worry about having additional panic attacks or their consequences
    • A significant maladaptive change in behavior related to the attacks
  • The disturbance is not attributable to the use of a substance, another medical condition, or another mental disorder.

Physical Examination

Children with panic disorder may have few physical findings, because the attacks rarely occur in the presence of a physician. Hyperventilation to the point of carpal-pedal spasm is rare.

Contributor Information and Disclosures

Jeffrey S Forrest, MD 

Disclosure: Nothing to disclose.


Nirupama Natarajan, MD Fellow in Child and Adolescent Psychiatry, Carilion Clinic, Virginia Tech Carilion School of Medicine

Nirupama Natarajan, MD is a member of the following medical societies: Academy of Psychosomatic Medicine, American Academy of Child and Adolescent Psychiatry, American Academy of Psychiatry and the Law, American Medical Association, American Psychiatric Association, American Society for Adolescent Psychiatry, Association for Academic Psychiatry, Medical Society of Virginia, Association of Clinical Research Professionals, American Association of Physicians of Indian Origin, American Society of Clinical Psychopharmacology, American Association for Emergency Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.


Chet Johnson, MD Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Lene Holm Larsen, PhD Instructor, Department of Child and Adolescent Psychiatry, Children's Memorial Hospital of Chicago

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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