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Related Experiment Videos

Rapid onset: a valid panic disorder criterion?

B S Scupi1, B E Benson, L B Brown

  • 1Unit on Anxiety Disorders, National Institute of Mental Health, NIH, Bethesda, MD 20892-1272, USA.

Depression and Anxiety
|January 1, 1997
PubMed
Summary
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The DSM-IV time criterion for panic disorder (PD) may not be clinically relevant, as prolonged onset panic attacks (PAs) showed no significant differences from rapid onset PAs in symptoms or illness course.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Research

Background:

  • The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) includes a time criterion for panic disorder (PD).
  • This criterion requires panic attacks (PAs) to have an abrupt onset with a time to peak intensity (TTPI) of less than 10 minutes.
  • The clinical utility of this specific time-based diagnostic criterion is not fully established.

Purpose of the Study:

  • To examine the diagnostic value of the DSM-IV time criterion for panic disorder (PD).
  • To compare panic disorder patients based on the time to peak intensity (TTPI) of their panic attacks (PAs).
  • To identify distinguishing features between rapid onset (TTPI < 10 min) and prolonged onset (TTPI > 10 min) panickers.

Main Methods:

Related Experiment Videos

  • Utilized data from 864 respondents to the National Institute of Mental Health Panic Disorder Questionnaire (NIMH PQ).
  • Participants met the initial three diagnostic criteria for PD.
  • Compared individuals with rapid onset PAs (81.8%) versus prolonged onset PAs (18.2%) across 100 clinical variables.

    • Main Results:

    • No significant differences were found between prolonged onset panickers and rapid onset panickers.
    • These differences were observed across 100 items assessing clinical symptoms, illness course, and comorbidity of PD.
    • A substantial proportion (18.2%) of patients meeting PD criteria exhibited prolonged TTPI for their PAs.

    Conclusions:

    • The DSM-IV time criterion (TTPI < 10 min) may not effectively differentiate patient subgroups within PD.
    • Patients with prolonged onset PAs often present with classic PD features and similar clinical profiles to rapid onset patients.
    • Further research is recommended to evaluate the reliability, validity, and clinical relevance of the current DSM-IV TTPI criterion for panic disorder.