Panic Disorder: Symptoms, Prevalence, Treatment and Current Researches

This assignment provides an overview of Panic Disorder, including its symptoms, prevalence rates, genetic basis, link to other disorders, and treatments. It also discusses current researches and provides recommendations for future studies.

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PANIC DISORDER (PD)
Student name

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Table of Contents
Panic disorder........................................................................................................................................2
Symptoms of panic disorder..............................................................................................................2
Prevalence rates................................................................................................................................2
The course of disorder.......................................................................................................................3
Genetic basis of panic disorder..........................................................................................................3
Link to other disorder........................................................................................................................3
Treatments........................................................................................................................................4
Psychotherapy...............................................................................................................................4
Medication.....................................................................................................................................4
Current researches............................................................................................................................5
Recommendations.............................................................................................................................6
References.............................................................................................................................................8

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Panic disorder
Panic disorder is the anxiety problem in which a person constantly suffers from
attacks of fear or panic. Everyone experience feelings of panic and anxiety at various times in
his or her life. The patient should have a complete physical exam, blood tests to identify the
thyroid and other likely conditions and tests on the heart like ECG (electrocardiogram). They
can also go through a psychological evaluation. Some of the self-assessment questionnaires
such as DSM 5 can be used to understand the situation.
Symptoms of panic disorder
Some of the physical symptoms of this mental disorder are increased heartbeat,
stomach or chest pain, difficulty in breathing, feeling cold hot or cold chills, sweating, and
tingling and numbness of hands (MedlinePlus, 2018). The criteria of the diagnosis of this
disorder include having frequent and unpredicted panic attacks. Minimum on of the attacks
has been tracked by single month worry related to having next attack; the constant fear of the
consequences of the attacks like dropping control, heart attack occurrence or going crazy; or
substantial changes in patient's behavior like escaping condition that they assume may
stimulate a panic attack. These attacks are not triggered by drugs or other constituent use, a
medical situation or another psychological health condition, like social fear, or obsessive-
compulsive disease (Mayoclinic, 2018).
Prevalence rates
An expected 2.7 percent of U.S. youth had a panic disorder in the previous year
(Olaya, Moneta, Miret, Ayuso-Mateos, & Haro, 2018). Nearly 4.7 percent of U.S. young
people experiences this disorder at least once in a life. The occurrence of this mental
condition among the primary care sick people is about twice as elevated as in the overall
population with rates of four to eight percent. The incidence of the panic condition among

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youth was higher for ladies (3.8%) than for men (1.6%) (Roy-Byrne, 2016). Ladies are twice
more probable to be impacted than men, and the sex difference is detected at initial stages of
adolescence (Roy-Byrne, 2016). The middle age of start for this disorder in the United States
is 20-24 years. The Asian, African, and some Latin American countries have inferior
prevalence rates that are ranges from 0.1 to 0.8 per cent (Roy-Byrne, 2016).
Course of disorder
This disorder may initiate at any stage of life, however, most persons develop this
condition between puberty and the mid-thirties. A slight number of panic disorder cases begin
in babyhood, and onset later the age of 45 is rare (but can occur). The middle age at the
beginning is 20-24 years (Roy-Byrne, 2016). The normal course, if not treated, is dangerous
or chronic but waning and waxing. Some people have a chronic, occasional course (with
irregular occurrences with years of reduction in between). Others have constant severe
symptomatology. While agoraphobia may grow at any stage, its onset is commonly within
the 1st year of panic disorder (Roy-Byrne, 2016).
Genetic basis of panic disorder
According to Smoller, Gardner‐Schuster, & Covino, (2008), panic disorders are found
to be familial and reasonably heritable. The genetic complication has an important influence
on panic disorder since it reproduces the preservative or interactive effects of numerous loci
with minor individual effects. Some initial studies suggest gene-gene connections. A study
defined a nominally important interaction among the functional 5-HTR1A 1019C/G and
COMT polymorphisms in panic disorder (Na, Kang, Lee, & Yu, 2011). The twin studies
constantly support the theory of genetic influences on the etiology of panic disorder.
However, these studies need further research and study (Na, Kang, Lee, & Yu, 2011).

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Link to other disorder
PD is associated with various other disorders such as anxiety disorder, depression,
PSTD, substance abuse, general phobias and agoraphobia, social phobias and OCD
(Obsessive Compulsive Disorder) (Internet Mental Health, 2018). This mental condition
somewhat linked to and leads to the PD. A report published in Internet Mental Health (2018),
reported that about one-third to one-half of persons identified with PD in community studies
also have agoraphobia.
Treatments
Treatment goals
The treatment goal of this disorder aims to recognize the symptoms of the disorder
and maintain the recurrences, and complications of the disorder. One of the main treatment
goals is to making sure that the vulnerability and exacerbation for panic disorder is reduced
and the care should be provided continuously.
Psychotherapy
Psychotherapy, also termed talk therapy, is found to be an effective principal choice
management for panic disorder. Psychotherapy can assist the patients to understand the panic
disorder and learn how to deal with it (Allen, White, Barlow, Shear, Gorman, & Woods,
2010). A type of psychotherapy named cognitive behavioral therapy (CBT) can help the
patient to learn, through their personal experience, that the panic signs are not unsafe. The
therapist can help them gradually to cure the symptoms of the panic attack in a harmless and
repetitive manner (Allen, White, Barlow, Shear, Gorman, & Woods, 2010).
Medication
Selective serotonin reuptake inhibitors (SSRIs)
Commonly safe with a little risk of severe adverse effects, SSRI antidepressants are
naturally suggested as the major choice of drugs to treat the issue. SSRIs approved and

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permitted by the Food and Drug Administration (FDA) for the management of panic disorder
for example, fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil, Pexeva) (Simon et
al., 2009).
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
These drugs are the type of antidepressants. The FDA approved for the management
of panic disorder is SNRI venlafaxine (Effexor XR) (Dell'Osso, Buoli, Baldwin, & Altamura,
2010).
Benzodiazepines
These sedative medicines are depressants of the central nervous system. The FDA
approved sedative is Benzodiazepines for the management of PD including clonazepam
(Klonopin) and alprazolam (Xanax). Benzodiazepines are commonly used only on a
temporary basis as they can habit-forming and causing psychological or physical dependency
(Otto, McHugh, Simon, Farach, Worthington, & Pollack, 2010).
These treatments are proven to be very effective in the management or treatment of
panic disorder and commonly used across the globe. Combination of antidepressants and
cognitive behavioral therapy (CBT) is more effective than using only antidepressants or CBT
(Cuijpers, Sijbrandij, Koole, Andersson, Beekman, & Reynolds III, 2014).
Current researches
According to Riske, Thomas, Baker, & Dursun, (2017), MCTs, HCAR1s, and
breakdown of lactate should be measured as potential markers when developing novel
medications for treating the Panic disorder and possibly preventing extrapyramidal adverse
effects resulting caused by the use of antipsychotics.

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Another recent study conducted by Graeff, (2017) found that Panic patients may not
have sufficient opioid buffering; results heightened feeling to suffocation and separation
anxiety. They also found that the exogenous opioids can also be used as a substitute or
adjunctive drug in the treatment of PD in drug-resistant panic patients. A recent study
conducted by Kemp (2018) found that exercise has a positive effect on decreasing anxiety
indications in panic disorder patients. However, the workout can be more effective as the
adjunctive therapy joined with the present first line treatment of cognitive behavioral therapy.
Recommendations
 Longer studies should be done on mental interventions centered on CBT for the patients
with the Panic disorder, to assess the long-term effectiveness of treatment and the
impacts of disturbance of the treatment (Cisler, Olatunji, Feldner, & Forsyth, 2010).
 Also, as outcome variables, the occurrence of panic attacks, including other variables
like proactive anxiety should also be comprised, in addition to standards for every aspect
of the disease (behavioral, cognitive, and “arousal” or activation state).
 The efficiency of psychodynamic psychotherapy on the patients with Panic disorder
needs to be better assessed, standardizing the study design and constantly using
randomized organized studies whenever conceivable (Mohr, Burns, Schueller, Clarke, &
Klinkman, 2013).
 The efficacy of other treatments such as counseling and brief family therapy for people
with PD needs to be assessed.
 The effectiveness of the psychological assistance presently accessible in primary care
must be studied with controlled randomized trials that are methodologically appropriate,
also assessing the influence on the consumption of psychoactive drugs in people with PD
(Cisler, Olatunji, Feldner, & Forsyth, 2010).

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 The presence of probable long-term adverse effects of the mixture of CBT and medical
treatment should be examined.
 Strategies must be industrialized and examined to treat a diseased person with refractory
Panic disorder or patients who respond only partially to the therapies (Livermore,
Sharpe, & McKenzie, 2010).

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References
Allen, L. B., White, K. S., Barlow, D. H., Shear, M. K., Gorman, J. M., & Woods, S. W.
(2010). Cognitive-behavior therapy (CBT) for panic disorder: Relationship of anxiety
and depression comorbidity with treatment outcome. Journal of Psychopathology and
Behavioral Assessment, 32(2), 185-192.
Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and
the anxiety disorders: An integrative review. Journal of psychopathology and
behavioral assessment, 32(1), 68-82.
Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds III, C.
F. (2014). Adding psychotherapy to antidepressant medication in depression and
anxiety disorders: a meta‐analysis. World Psychiatry, 13(1), 56-67.
Dell'Osso, B., Buoli, M., Baldwin, D. S., & Altamura, A. C. (2010). Serotonin-
norepinephrine reuptake inhibitors (SNRIs) in anxiety disorders: a comprehensive
review of their clinical efficacy. Human Psychopharmacology: Clinical and
Experimental, 25(1), 17-29.
Graeff, F. G. (2017). A translational approach to the pathophysiology of panic disorder:
Focus on serotonin and endogenous opioids. Neuroscience & Biobehavioral
Reviews, 76, 48-55.
Internet Mental Health (2018). Panic disorder. Retrieved from:
https://www.mentalhealth.com/home/dx/panic.html

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Kemp, D. (2018). Is Exercise an Effective Treatment for Reducing Anxiety in Patients with
Panic Disorder?. Retrieved from:
https://digitalcommons.pcom.edu/pa_systematic_reviews/367/
Livermore, N., Sharpe, L., & McKenzie, D. (2010). Panic attacks and panic disorder in
chronic obstructive pulmonary disease: a cognitive behavioral
perspective. Respiratory Medicine, 104(9), 1246-1253.
Mayoclinic (2018). Panic attacks and Panic disorder. Retrieved from:
https://www.mayoclinic.org/diseases-conditions/panic-attacks/diagnosis-treatment/
drc-20376027
medlinePlus (2018). Panic disorder. Retrieved from:
https://medlineplus.gov/panicdisorder.html
Mohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013). Behavioral
intervention technologies: evidence review and recommendations for future research
in mental health. General hospital psychiatry, 35(4), 332-338.
Na, H. R., Kang, E. H., Lee, J. H., & Yu, B. H. (2011). The genetic basis of the panic
disorder. Journal of Korean medical science, 26(6), 701-710.
Olaya, B., Moneta, M. V., Miret, M., Ayuso-Mateos, J. L., & Haro, J. M. (2018).
Epidemiology of panic attacks, panic disorder and the moderating role of age: Results
from a population-based study. Journal of affective disorders, 241, 627-633.
Otto, M. W., McHugh, R. K., Simon, N. M., Farach, F. J., Worthington, J. J., & Pollack, M.
H. (2010). Efficacy of CBT for benzodiazepine discontinuation in patients with panic
disorder: further evaluation. Behavior research and therapy, 48(8), 720-727.

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Riske, L., Thomas, R. K., Baker, G. B., & Dursun, S. M. (2017). Lactate in the brain: an
update on its relevance to brain energy, neurons, glia, and panic disorder. Therapeutic
advances in psychopharmacology, 7(2), 85-89.
Roy-Byrne, P. P. (2016). Panic disorder in adults: Epidemiology, pathogenesis, clinical
manifestations, course, assessment, and diagnosis. Retrieved from:
https://www.uptodate.com/contents/panic-disorder-in-adults-epidemiology-
pathogenesis-clinical-manifestations-course-assessment-and-diagnosis
Simon, N. M., Otto, M. W., Worthington, J. J., Hoge, E. A., Thompson, E. H., LeBeau, R. T.,
... & Pollack, M. H. (2009). Next-step strategies for panic disorder refractory to initial
pharmacotherapy. The Journal of clinical psychiatry, 70(11), 1563.
Smoller, J. W., Gardner‐Schuster, E., & Covino, J. (2008, May). The genetic basis of panic
and phobic anxiety disorders. In American Journal of Medical Genetics Part C:
Seminars in Medical Genetics, 148(2), 118-126.