From the Guidelines
Yes, it is possible to have Post-Traumatic Stress Disorder (PTSD) and Panic Disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) 1.
DSM Criteria
The DSM-5 characterizes anxiety disorders, including PTSD and Panic Disorder, as developmentally inappropriate, excessive worry or distress associated with specific objects, situations, or events 1.
- PTSD is not explicitly listed as an anxiety disorder in the provided DSM-5 criteria 1, but it is mentioned in the context of anxiety disorders in the management of anxiety and depression in adult survivors of cancer 1.
- Panic Disorder is characterized by recurrent unexpected panic attacks with physical and cognitive manifestations 1.
Comorbidity
The DSM-5 allows for the diagnosis of multiple mental disorders, including anxiety disorders, if the diagnostic criteria for each disorder are met 1.
- Comorbidities are common in anxiety disorders, and patients with one anxiety disorder may be at increased risk of developing another 1.
Diagnosis
A diagnosis of PTSD and Panic Disorder requires a comprehensive evaluation, including a thorough medical and psychological history, and the use of standardized assessment tools 1.
- Screening tools, such as the GAD-7 scale, can be used to identify patients with anxiety disorders, including PTSD and Panic Disorder 1.
- Referral to a mental health professional may be necessary for patients with moderate to severe symptoms or for those who require specialized treatment 1.
From the Research
Comorbidity of PTSD and Panic Disorder
- According to the study 2, individuals with PTSD have high comorbidities with other psychiatric diseases, including generalized anxiety disorder, which can encompass panic disorder.
- The study 3 found that 35.4% of participants with panic attacks scored above the cutoff for PTSD, indicating a significant overlap between the two conditions.
- Another study 4 explored the intersection of panic disorder, dissociation, and complex post-traumatic stress disorder, suggesting that patients with panic disorder may experience increased vulnerability to dissociative and anxious phenomena in the presence of repeated traumatic events.
Diagnostic Considerations
- The study 5 found that experienced clinicians can distinguish PTSD from other diagnostic categories, including major depressive disorder and generalized anxiety disorder, which can encompass panic disorder.
- The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) offers diagnostic guidelines for PTSD, which can co-occur with other conditions, including panic disorder 2.
- The study 6 compared the autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder, finding distinct psychophysiological profiles for each condition, but also highlighting the potential for comorbidity.
Clinical Implications
- The presence of PTSD can exacerbate anxiety symptoms in patients with panic disorder, and vice versa 4.
- Early intervention programs and prevention strategies are needed to address the potential link between dissociative symptoms and a more severe clinical course of anxiety-related conditions in patients with panic disorder and PTSD 4.
- A combination of psychotherapy and pharmacotherapy is used to treat PTSD, but has limited efficacy in patients with refractory PTSD, highlighting the need for further research into effective treatments for comorbid conditions 2.