Defining Panic—a Diagnostic Dilemma

Patients with panic disorder exhibit an array of physical and psychological symptoms. However, the disorder shares some similarities and is often comorbid with other psychiatric conditions, including other anxiety disorders and depression. Differential diagnosis of panic disorder is important to ensure appropriate treatment. Panic disorder can be qualitatively distinguished from generalized anxiety disorder: panic attacks occur suddenly, have a shorter duration, and there are more physical symptoms which are accompanied by distinct psychological symptoms such as fear of dying, going crazy or losing control. Panic disorder and depression can also be differentiated: depression, but not panic disorder, is characterized by early morning awakening, loss of appetite, inability to concentrate, daily mood fluctuation, sexual dysfunction and loss of capacity for enjoyment. Non‐clinical panic, nocturnal panic and limited‐symptom attacks exhibit biological similarities to classical panic disorder and can be classed as valid subtypes. © 1997 John Wiley & Sons, Ltd.