Diagnosis of Panic Disorder

Diagnosis of panic disorder can be difficult because several other physical and mental disorders are associated with panic attacks. You will need a thorough physical and mental evaluation before a proper diagnosis can be made. Diagnosis of panic attack is based on a proper evaluation and the criteria outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

In the DSM-IV, panic disorder is defined as recurrent, unexpected panic attacks followed by at least one month of persistent concern about having another attack, worry about the consequences of panic attacks, and a change in behavior as a result of the attacks.

Your healthcare provider will conduct an evaluation that may include the following:

Initial Assessment – Your healthcare provider will ask about the following:

  • Your medical history
  • Symptoms you experience during an attack
  • How long you have been having the attacks
  • When the attacks started
  • How often they occur
  • When and where they tend to occur
  • How long they last
  • What effect they have on your ability to function

Evaluation of Medical Disorders – Your healthcare provider will also look for and rule out medical disorders that could cause your symptoms. Medical conditions commonly associated with panic disorder include hyperthyroidism , cardiac arrhythmias , mitral valve prolapse , Cushing’s syndrome , carcinoid syndrome, Parkinson’s disease treated with levodopa, heart attack, pulmonary embolus, episodic hypoglycemia, mastocytosis, and pheochromocytoma . Your healthcare provider should also ask about your intake of medications, foods, herbal supplements, and vitamins.

Evaluation for Substance Abuse – Use or withdrawal from addictive substances can cause symptoms of panic. Substances that can cause symptoms of panic include stimulants such as cocaine and caffeine. Your healthcare provider may also ask about your use of alcohol, nicotine, addictive medications (particularly sedatives), illegal drugs, and other substances.

Evaluation of Other Psychiatric DisordersDepression , generalized anxiety disorder , social phobia , substance abuse, and personality disorders often occur with panic disorder. You may be evaluated for these and other disorders.


National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/ .

Abnormal Psychology . 8th ed. Alloy, Jacobson, and Acocella; 2000.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia: Elsevier Mosby; 2004.

Last reviewed February 2007 by Edward R. Rosick, DO, MPH, MS

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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