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Signs and Symptoms

Panic Attack

Diagnostic Criteria

Symptom List

Panic Disorder

Without Agoraphobia

Diagnostic Criteria

Panic Disorder

With Agoraphobia

Diagnostic Criteria

Criteria for Panic Attack

A person experiences a discrete period of intense fear or discomfort:

It occurs suddenly

It reaches a peak within 10 minutes:

A person experiences four (or more) of the following 13 symptoms

Panic Attack Symptom List

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
10. Fear of losing control or going crazy
11. Fear of dying
12. Paresthesias (numbness or tingling sensations)
13. Chills or hot flushes

Note

Panic Attack is not a codable disorder.

Code the diagnosis in which the Panic Attack occurs:

1. Panic Disorder
2. Panic Disorder With Agoraphobia

Return to Signs and Symptoms

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Panic Disorder Diagnostic Criteria

Diagnostic criteria for 300.01 Panic Disorder Without Agoraphobia

• A. Both (1) and (2):
  1. Recurrent unexpected Panic Attacks
  2. At least one of the attacks has been followed by at least one month with at least one of the following:
     1. Persistent concern about having additional attacks
     2. Worry about the implications of the attack or its consequences

        EXAMPLES:

        Losing control

        Having a heart attack

        "Going crazy"

     3. A significant change in behavior related to the attacks
• B. Absence of Agoraphobia
• C. The Panic Attacks are not due to the direct physiological effects of:
  1. A substance
  2. A general medical condition
• D. The Panic Attacks are not better accounted for by another mental disorder:

  Social Phobia

  Panic attacks occur in feared social situations

  Specific Phobia

  Panic attacks occur a specific phobic situation

  Obsessive-Compulsive Disorder

  Panic attacks occur with exposure to dirt with an contamination obsession

  Post-traumatic Stress Disorder

  Panic attacks occur in response to stimuli associated with a severe stressor

  Separation Anxiety Disorder

  Panic atttack occur while being away from home or close relatives

Return to Signs and Symptoms

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Panic Disorder Diagnostic Criteria

Diagnostic criteria for 300.21 Panic Disorder With Agoraphobia

• A. Both (1) and (2):
  1. Recurrent unexpected Panic Attacks
  2. At least one of the attacks has been followed by at least one month with at least one of the following:
     1. (a) Persistent concern about having additional attacks
     2. (b) Worry about the implications of the attack or its consequences

        EXAMPLES:

        Losing control

        Having a heart attack

        "Going crazy"

     3. (c) A significant change in behavior related to the attacks
• B. The presence of Agoraphobia
• C. The Panic Attacks are not due to the direct physiological effects of:
  1. A substance
  2. A general medical condition
• D. The Panic Attacks are not better accounted for by another mental disorder:

  Social Phobia

  Panic attacks occur in feared social situations

  Specific Phobia

  Panic attacks occur a specific phobic situation

  Obsessive-Compulsive Disorder

  Panic attacks occur with exposure to dirt with an contamination obsession

  Post-traumatic Stress Disorder

  Panic attacks occur in response to stimuli associated with a severe stressor

  Separation Anxiety Disorder

  Panic atttack occur while being away from home or close relatives

Return to Signs and Symptoms

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Agoraphobia Diagnostic Criteria

---

Criteria for Agoraphobia

Note Regarding Coding

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Criteria for Agoraphobia

• A. Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms. Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile.

  NOTE:

  Consider the diagnosis of Specific Phobia:

  If the avoidance is limited to one or only a few specific situations

  Consider the diagnosis of Social Phobia

  If the avoidance is limited to social situations.

• B. The situations are avoided (e.g., travel is restricted) or else are endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion.
• C. The Agoraphobia is not better accounted for by another mental disorder:

  Social Phobia

  Panic attacks occur in feared social situations

  Specific Phobia

  Panic attacks occur a specific phobic situation

  Obsessive-Compulsive Disorder

  Panic attacks occur with exposure to dirt with an contamination obsession

  Post-traumatic Stress Disorder

  Panic attacks occur in response to stimuli associated with a severe stressor

  Separation Anxiety Disorder

  Panic atttack occur while being away from home or close relatives

Return to Agoraphobia Diagnostic Criteria

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Note Regarding Coding

Agoraphobia is not a codable disorder.

Code the disorder in which the Agoraphobia occurs:

1. Panic Disorder With Agoraphobia (300.21)
2. Agoraphobia Without History of Panic Disorder (300.22)

Return to Agoraphobia Diagnostic Criteria

Return to Signs and Symptoms

References:

⁽¹⁾DSM-IV, American Psychaitric Association, 1994.