Diagnostic Criteria for Panic Attacks according to DSM IV

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

- Palpitations, pounding heart, or accelerated heart rate;
- Sweating;
- Tremors fine or a big shock;
- Wheezing or choking feeling;
- Feeling of choking;
- Pain or discomfort in the chest;
- Nausea or abdominal discomfort;
- Feeling dizzy, unsteady, light-headed or fainting;
- Derealization (feelings of unreality) or depersonalization (being detached from oneself);
- Fear of losing control or going crazy;
- Afraid of dying;
- Paresthesias (numbness or tingling sensations);
- Chills or hot flushes.


The essential feature is a discrete period of intense fear or discomfort accompanied by at least four somatic or cognitive symptoms of 13. The attack has a sudden onset, rapidly reaches its peak (usually 10 minutes) and is often accompanied by a sense danger or impending doom.

Individuals seeking care for unexpected panic attacks usually describe the fear as intense and report that they thought they were about to die, to lose control of having a myocardial infarction, going crazy. They also report the desire to escape from the place where the attack is occurring.

Dyspnea is a common symptom in the attacks associated with panic disorder with and without agoraphobia. And 'common blush during panic attacks situational anxiety related social or performance.

The anxiety characteristic can be differentiated from generalized anxiety by its intermittent nature, almost paroxysmal and severity typically greater. It 'important to consider the context in which it occurs the attack.

There are three types of attacks characteristic with different relationships between the onset of the attack and the presence or absence of situational factors triggered:

- Unexpected panic attacks in which the onset is not associated with a trigger situational;

- Panic attacks caused by the situation (caused) in which the attack almost invariably occurs immediately during the exhibition or in expectation of the stimulus or trigger situational;

- Panic attacks sensitive to the situation, who are more likely to occur following exposure to the stimulus or situational factor unleashed, but they are invariably associated with the stimulus and necessarily occur immediately after exposure.

For diagnosis it required the occurrence of unexpected attacks.