Panic Disorder

Introduction

Panic disorder (PD) is a type of anxiety disorder and is characterised by recurrent episodes of panic attacks and the development of fear, worries and anxiety regarding the possibility of future attacks, along with several physical symptoms. The unpredictable recurrence of new panic attacks may cause sufficient fear and lead to severe avoidance behaviour and anticipatory anxiety (Lepola et al., 1996c).

Panic attacks are characterised by sudden and unexpected distinct periods of intense fear, nervousness or apprehension, terror, panic or discomfort. They are often accompanied by physical symptoms, such as shortness of breath, dizziness, palpitations, angina, excessive perspiration, trembling, nausea or abdominal distress; and cognitivesymptoms such as depersonalisation or derealisation, and the fear of losing control, going crazy, having a heart attack, or even dying (Roy-Byrne, 1992). These somatic experiences lead many patients to seek care in non-psychiatric settings, such as emergency rooms and physicians' offices (Gorman and Papp, 1990; Katerndahl and Realini, 1995; Bouwer et al., 1997) and patients suffering from PD use healthcare services at rates higher than usual. In one study, PD was found to be associated with greater demand for general, emergency and psychiatric services than any other psychiatric diagnosis (Katon et al., 1992).