Potential questions on Panic Disorder . Answers based on DSM-IV-TR, APA Practice Guideline, and other references that as identified on the specific screen. As of August 1, 2006. . Criteria of “panic attack”. Q. DSM criteria, very general?. Ans. Outline of Dx of Panic Disorder.
Answers based on DSM-IV-TR, APA Practice Guideline, and other references that as identified on the specific screen. As of August 1, 2006.
Q. DSM criteria, very general?
Q. DSM expects at least 4 of 13 symptoms in stating the pt has had a “panic attack.” List as many of the 13 as you can.
Q. Names some key rule outs to making the dx of panic disorder.
Q. What are laboratory findings?
Ans. None are specific to panic disorder, but pts with this disorder do tend to have panic attacks with an infusion of Na+ lactate than those without the disorder.
Q. Which is more common Panic Disorder with agoraphobia or panic disorder without agoraphobia?
Ans. Panic Disorder without agoraphobia is twice as common.
Q. Gender breakdown?
Ans. Women to men: two to one says Practice Guideline, Some say three to one.
Q. Age at onset?
Ans. Bimodal onset:
Q. Lifetime Prevalence?
Q. Annual Prevalence?
Q. Prevalence in Primary Care Practice?
Ans. 3 – 8 %
Q. A common place for people with panic disorder to enter the health care system?
Ans. Common entry point is the ER
Q. When to hospitalize a pt with panic disorder?
Ans. Only hospitalize if there is another psychiatric disorder present that so justifies.
Q. What are risk factors for panic disorder?
Ans. 1. Genetic, higher in monozygotic than dizygotic twins and 8 times as common among close relatives.
Ref : NEJM 2006; 354:2360-7
Q. What percentage will have comorbid psych disorders during their lifetime?
Ans. Lifetime comorbid disorders: 90%
Q. What conditions can mimic a panic attack?
Ans. Potential mimics:
Too much coffee and other stimulants
Q. Why screen for depression?
Ans. Screen for depression to ascertain if pt also has depressive disorder. An associated depression increases risk of suicide.
Q. What is suicide rate?
Ans. Practice Guideline says 1/5, but NEJM article implies that is so because so many are also depressed. Still, it would seem that “1/5” would be correct answer.
Q. Which three personality disorders have high co-occurrence with panic disorder?
Ans. Common co-occurring personality disorders:
Q. Which five classes of meds have been shown to be the most efficacious? [“Efficacious” implies potency alone, not related to more general issues as to the use of the med.]
Ref: NEJM 2006; 354:2360-7
Q. Which of the five classes of meds in the prior screen is preferred for pts with panic attacks?
Q. What about using bupropion in pts with panic attacks?
Q. What about propranolol use in pts with panic disorders?
Q. After selecting the medication, what is medication strategy for panic disorders?
Q. Goal of medication treatment in pts with panic disorders?
Q. If the First Choice SSRI is not effective, what to do?
1. CBT or
2. Another SSRI
Q. If two SSRIs have failed?
[Ref: NEJM 2006; 354:2360-7]
Q. For panic disorder, of what does CBT consist?
Q. What about other psychotherapies? Are there any controlled studies?