Sunday, November 30, 2014

Panic disorder ;

Rajendra  is a 20-year-old student who fell to the ground in the supermarket. He did not lose consciousness. He says he suddenly felt very unwell, as if something terrible was going to happen to him.

Then he felt sweaty, he could not breathe properly and his heart began to race as he slumped to the ground. You are seeing him in the Emergency department.

physical tests are normal. However, he continues to appear very anxious. He describes several previous similar episodes over the last 9 months.

he has no psychiatric history, with no recent stressful events. He gets about two of these episodes every month – usually in crowded places – but they are unpredictable.

What is the most likely psychiatric diagnosis here?

Panic disorder.

 Recurrent episodes of sudden onset, severe anxiety symptoms that occur in various (sometimes
similar) situations:
• Episodes are random, and not as predictable as a phobia .
• Episodes usually terminate within minutes, at most 30 minutes
• Panic disorder is frequently associated with agoraphobia (e.g. a specifi c fear of crowds, shopping centres, football grounds)


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