[Stress, anxiety, panic. Panic attack and panic disorder. A new psychiatric concept]

Area of Science:

• Psychiatry
• Clinical Psychology

Context:

• The traditional unitary model of anxiety neurosis has been superseded by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III).
• The DSM-III introduced "panic disorder" and "panic attacks" as central to the construct of anxiety, supported by evidence of antidepressant efficacy.
• Behavioral and cognitive therapies are recognized for their utility, particularly in managing anxiety with agoraphobia.

Purpose:

• To review the clinical aspects, differential diagnosis, and treatment modalities for pathological anxiety, with a focus on panic disorder.
• To examine the pharmacological induction of panic attacks using agents like lactate and caffeine.
• To discuss the shift in diagnostic paradigms from anxiety neurosis to panic disorder.

Summary:

• Pathological anxiety is defined as stress perception with cognitive distortion.
• The DSM-III framework emphasizes panic disorder and panic attacks, informed by the efficacy of antidepressant medications.
• General anxiety disorder is now often classified as a residual category.
• The review encompasses clinical presentations, diagnostic challenges, triggers for panic attacks (e.g., lactate, caffeine), and therapeutic interventions.

Impact:

• This shift in understanding facilitates more targeted diagnostic and therapeutic strategies for anxiety disorders.
• Highlights the importance of pharmacological and psychotherapeutic interventions in managing panic disorder and related conditions.
• Provides a comprehensive overview for clinicians and researchers navigating the complexities of anxiety disorder classification and treatment.