History
Children with panic disorder may experience the following somatic symptoms during discrete panic attacks:
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Dyspnea and/or palpitations with or without tachycardia
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Diaphoresis
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Nausea and/or diarrhea
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Urinary urgency
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Cold and clammy hands
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Dry mouth
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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]
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Recurrent unexpected panic attacks
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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
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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.
