Overview
Panic disorder without agoraphobia is characterized by recurrent unexpected panic attacks and persistent concern about having another attack, without significant avoidance of situations due to fear of panic. [Not directly addressed in provided abstracts]Diagnosis
Recurrent unexpected panic attacks [Not directly addressed in provided abstracts]
Persistent concern about having another attack or worry about the implications of the attack [Not directly addressed in provided abstracts]
Not meeting criteria for agoraphobia [Not directly addressed in provided abstracts]Management
First-line pharmacotherapy: Selective Serotonin Reuptake Inhibitors (SSRIs) such as sertraline or paroxetine [Not directly addressed in provided abstracts]
Cognitive Behavioral Therapy (CBT) is recommended as a first-line psychological treatment [Not directly addressed in provided abstracts]
Adjunctive treatments may include benzodiazepines for short-term relief, though use should be cautious due to potential for dependence [Not directly addressed in provided abstracts]Special Populations
Pediatrics: Limited evidence in abstracts regarding specific management in pediatric populations 1
Elderly: No specific guidance provided in abstracts regarding elderly patients [Not directly addressed in provided abstracts]
Comorbidities: No specific recommendations for managing panic disorder in the context of comorbidities within the provided abstracts [Not directly addressed in provided abstracts]Key Recommendations
Enhance training in recognizing and treating psychological impacts of disasters, including panic disorders, among front-line healthcare providers 12 (Evidence: Moderate)
Occupational health professionals should receive more intensive training to adequately prepare for mental health counseling in the aftermath of terrorist attacks 2 (Evidence: Moderate)
Front-line physicians should engage in local emergency preparedness planning initiatives to better recognize and manage psychological casualties, including children 1 (Evidence: Moderate)References
1 Martin SD, Bush AC, Lynch JA. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs. Pediatrics 2006. link
2 Gershon RR, Gemson DH, Qureshi K, McCollum MC. Terrorism preparedness training for occupational health professionals. Journal of occupational and environmental medicine 2004. link