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Introduction

Panic disorder is characterized by recurrent, unexpected anxiety attacks that result in fear of future attacks and/or maladaptive changes in behavior (eg, restricting activities).  Anxiety or panic attacks involve an abrupt surge of fear and multiple physical and cognitive symptoms (eg, palpitations, chest pain, fear of dying).  Patients may have high levels of social and occupational impairment due to unpredictable symptoms and avoidance behaviors.

Epidemiology and risk factors

The lifetime prevalence rate of panic disorder is estimated to be approximately 1.7%, with a 2:1 female-to-male ratio.  The median age at onset is 20-24.

Several factors increase the risk of developing panic disorder, including genetic (eg, first-degree relative with anxiety and/or depressive or bipolar disorders), environmental (eg, relationship strain, death of a relative, decline in health), and psychologic (eg, neuroticism, anxiety sensitivity) factors.

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