Panic Disorder DSM-5 300.01 (F41.0) (2023)

Panic Disorder DSM-5 300.01 (F41.0) (1)

DSM-5 Category: Anxiety Disorders


The DSM-5 describes a panic attack as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes.” (American Psychiatric Association, 2013). These attacks are recurrent and unanticipated by the patient. Panic disorder can cause a variety of interpersonal and occupational problems. Individuals with recurrent panic may avoid social situation or going out in public altogether. These patients try to avoid a potentially embarrassing attack. This can lead to withdrawal from friends and family; and absence from work and school. Thankfully, panic disorder can be treated. Dialectical behavior therapy is among most effective treatments for panic disorder (American Psychiatric Association, 2013).

Symptoms of Panic Disorder

According to the DSM-5, the most prominent diagnostic criterion for panic disorder is recurrent unexpected panic attacks. Because the panic attacks are unexpected, they are impossible to predict, and the patient usually feels that they “come out of the blue.” This surge of fear can occur during a time of existing anxiety but can also begin during calm state, such as while relaxing, sleeping or while engaging in an enjoyable activity. Common features of panic attacks include an accelerated heart rate or pounding heart beats, chest pain, sweating, trembling, shortness of breath, a choking sensation, nausea, dizziness or light-headedness ,numbness, chills or heat, a feeling of being detached from one’s self, fear of losing control and fear of dying. In addition to these attacks, the patient experiences persistent worry or fear of having a panic attack and often changes behaviors and routines to avoid panic attacks. These symptoms are not related to substance use, or other medical or psychiatric condition (American Psychiatric Association, 2013).

Social Issues

People who experience unexpected panic attacks often become fearful of experiencing a sudden panic attack at work, with friends, or in public. They are concerned that they may be judged for their behavior or lose control; resulting in perceived embarrassment. These fears often lead people to change their habits in order to avoid a public panic attack. For example, a woman with recurrent panic attacks may stop taking public transportation, stop going to the gym and stop attending church. She may decline invitations to parties and other events. People who suffer from frequent panic attacks may miss work or school. This can lead to social isolation, causing feelings of sadness and problems within relationships. Friends and family members may be affected by these changes in social behavior (American Psychiatric Association, 2013).

(Video) D.Bastien, Interventions, Panic Disorder 300.01(F41.0) Part 1

Additionally, the physical symptoms of panic attacks often lead patients to be concerned about illness or acute medical conditions (American Psychiatric Association, 2013). Symptoms such as chest pain, heart palpitations, and faintness can closely mimic the symptoms of serious cardiac conditions. Many patients with panic disorder are first diagnosed when they seek emergency care for what they believe is a heart attack. In fact, the majority of noncardiac chest without medical cause is attributed to anxiety and panic (Achiam-Montal, Tibi & Lipsitz, 2013). Patients who suffer from asthma are also at increased risk for panic disorder. Sometimes, patients who suffer from recurrent panic attacks turn to drugs or alcohol to manage symptoms. Several medications are useful in managing panic disorder, but they are often highly addictive (American Psychiatric Association, 2013).

Risk Factors

In the United States and Europe, the prevalence of panic disorder is between 2% and 3% for adults and adolescents. According to the DSM-5, several risk factors have been identified. Temperament is one well-documented risk factor of panic disorder. Individuals who experience anxiety or have a history of being fearful are at increased risk of developing panic disorder. Environmental risk factors are also common. People who experience childhood physical or sexual abuse are at increased risk for developing panic disorder (American Psychiatric Association, 2013). Recent studies examining twins estimate that the heritability of panic disorder is 30-40% (Spatola, et al., 2011). Although no specific gene related to panic disorder has been indentified, the DSM-5 explains that multiple genes may make individuals particularly sensitive to panic. Individuals whose parents experienced depression, anxiety or bipolar disorder are at an increased risk of developing panic disorder (American Psychiatric Association, 2013).

Treatment of Panic Disorder

Although medications exist to ease anxiety and reduce panic attack, they are largely ineffective without therapy. Dialectical Behavioral Therapy consists of individual therapy, group therapy, and telephone consultation. During individual therapy, the patient can work on skills to overcome interpersonal problems that may lead to anxiety; as well as skills for reducing and dealing with panic attacks. In group therapy, the patient can discuss current problems with others who are experiencing similar challenges. Dialectical behavior therapy patients have access to call their therapist at any time. This is helpful for getting through crisis situations such as a sudden, unexpected panic attack (Chapman, et al., 2011).

Several important skills are strengthened during each component of dialectical behavioral therapy. Mindfulness skills help patients to live in the “here and now” and focus on present experiences. Emotion regulation skills help the patient to indentify emotions and reduce feelings that create vulnerability to anxiety. Interpersonal skills help patients related to others in a healthy way. Many times, recurrent panic leads patients to fear social situation. Distress tolerance skills help patients deal with crisis as well as overwhelming situations and emotional states. Dialectical behavior theory places a strong emphasis on balance. In most cases, this is a balance between acceptance and change. Change can be very difficult, even threatening to those who suffer from panic disorder. Accepting panic can help the patient focus on other issues that may create the panic (Chapman, et al., 2011).

(Video) Panic Attack & Panic Disorder as per DSM 5 | Symptoms, Therapeutic Treatment & Medication

Treating panic disorder in children is similar to treating panic disorder in adults. However, the addition of family therapy is an important component. In family therapy, the child’s parents or primary caregiver can become educated about panic disorder and the child’s treatment plan. When parents are cooperative with the plan, treatment outcomes are more successful. Because children do not actively seek treatment, they may be resistant or less cooperative than patients who seek out their own treatment. Creating a positive therapeutic alliance among parents, therapist and child is the best way to motivate a child to participate in the therapy process (Beidel & Alfano, 2011).


Achiam-Montal, M., Tibi, L. & Lipsitz, J.D. Panic disorder in children and adolescents with noncardiac chest pain. Child Psychiatry and Human Development. 44(6): 742-50

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

(Video) F41.0 – Krankheit [remastered bonus track]

Beidel, D.C. &Alfano, C.A. Child anxiety disorder: A guide to research and treatment. New York: Routledge.

Chapman, A., Gratz, K., Tull, M. & Keane, T. (2011). The dialectical behavior therapy skills workbook for anxiety : Breaking free from worry, panic, PTSD, and other anxiety symptoms. Oakland: New Harbinger Publications.

Spatola, C.A.M., Scaini, S., Pesenti-Gritti, P., Medland, S.E., Moruzzi, S., Ogliari, A., Tambs, K., Battaglia, M. (2011). Gene-environment interactions in panic disorder and CO₂ sensitivity: Effects of events occurring early in life. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 156(1): 79-88

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What does F41 0 mean? ›

ICD-10 code: F41.0. Panic disorder is part of a cluster of diagnoses called the anxiety disorders. Anxiety disorders are a group of psychiatric conditions that include: Generalized anxiety disorder.

How do you score the panic disorder Severity Scale? ›

Scoring and Interpretation

Each item on the measure is rated on a 5-point scale (0=Never; 1=Occasionally; 2=Half of the time; 3=Most of the time, and 4=All of the time). The total score can range from 0 to 40, with higher scores indicating greater severity of panic disorder.

What are the 4 different types of panic disorders? ›

Panic disorders are often classified into six types, including anxiety disorders, phobias and more.
  • Panic Disorder (Characterized by Anxiety or Panic Attacks) ...
  • Generalized Anxiety Disorder (GAD) ...
  • Obsessive-Compulsive Disorder (OCD) ...
  • Phobias. ...
  • Social Anxiety Disorder. ...
  • Post-Traumatic Stress Disorder (PTSD)

Is panic disorder an anxiety disorder DSM-5? ›

Panic disorder is classified as an anxiety disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to the guidelines, in order to be diagnosed with panic disorder, you must experience unexpected panic attacks on a regular basis.

What is a high anxiety score? ›

Extremely difficult. * Score: 5 to 9 = mild anxiety; 10 to 14 = moderate anxiety; 15 to 21 = severe anxiety.

What are the three basic types of panic attacks? ›

Multidimensional scaling (MDS) of panic symptoms identified three types of panic which were consistent over time and for which reliable scales were constructed to measure derealization, cardiac panic, and respiratory panic.

How is a panic disorder diagnosed? ›

How is panic disorder diagnosed? Your healthcare provider or a mental health professional may diagnose you with panic disorder based on your symptoms. Generally, if you have 4 or more panic attacks and if you are in constant fear of having another, you have panic disorder.

What is the assessment for panic disorder? ›

The Panic Disorder Severity Scale (PDSS) is a self report scale that measures the severity of panic attacks and panic disorder symptoms. It is appropriate for use with adolescents (13+) and adults.

What are 5 signs of panic disorder? ›

Symptoms include:
  • a racing heartbeat.
  • feeling faint.
  • sweating.
  • nausea.
  • chest pain.
  • shortness of breath.
  • trembling.
  • hot flushes.

What are 5 characteristics of panic disorder? ›

Chills or heat sensations. Paresthesias (ie, numbness or tingling sensations) Derealization (ie, feeling of unreality) or depersonalization (ie, being detached from oneself) Fear of losing control or going crazy.

What are 3 treatments for panic disorder? ›

Panic disorder is generally treated with psychotherapy (sometimes called “talk therapy”), medication, or both. Speak with a health care provider about the best treatment for you.

Is panic disorder a serious mental illness? ›

Left untreated, panic disorder can become a very debilitating and isolating illness. It can also increase your risk of developing other mental health conditions, such as agoraphobia or other phobias.

Is a panic disorder a disability? ›

Anxiety disorders such as obsessive compulsive disorder (OCD), panic disorders, phobias or post-traumatic stress disorder (PTSD) are considered a disability by the Social Security Administration (SSA).

What is the difference between being in a panic and a panic disorder? ›

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

What does anxiety F41 1 mean? ›

ICD-10 Code F41.1. Generalized anxiety disorder (GAD) is part of a cluster of diagnoses called the anxiety disorders. Anxiety disorders are a group of psychiatric conditions that include: Generalized anxiety disorder.

What does diagnosis F41 1 mean? ›

Anxiety that is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is "free-floating").

What is the first line treatment for panic disorder? ›

Psychotherapy. Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.

What are the 5 levels of anxiety? ›

The five major types of anxiety disorders are:
  • Generalized Anxiety Disorder. ...
  • Obsessive-Compulsive Disorder (OCD) ...
  • Panic Disorder. ...
  • Post-Traumatic Stress Disorder (PTSD) ...
  • Social Phobia (or Social Anxiety Disorder)

Are there four levels of anxiety? ›

The four levels of anxiety are mild anxiety, moderate anxiety, severe anxiety, and panic level anxiety, each of which is classified by the level of distress and impairment they cause.

Which brain part is most responsible for panic attacks? ›

The Amygdala houses the “fight or flight” response and a part of the “emotional” side of the brain. It is thought those suffering from a panic disorder experience an overactive Amygdala, characterized by an intense fear of something taking over the senses.

What are silent panic attacks? ›

Your heart rate increases or feels like its skipping a beat: If your heart rate is faster than normal, or you begin to have heart palpitations, it could be a sign of a silent panic attack. It also may be one of the first physiological symptoms you experience with any sort of anxiety.(Pexels)

What is the 333 rule for panic attacks? ›

It involves looking around your environment to identify three objects and three sounds, then moving three body parts. Many people find this strategy helps focus and ground them when anxiety overwhelms them.

What happens to your body when you have panic disorder? ›

While symptoms vary from person to person, they can include a pounding heart, shortness of breath, light-headedness, sweating, trembling, nausea, tingling or numbness in the fingers and toes, and an overwhelming sense of impending doom.

What are warning signs of panic disorder? ›

Symptoms during a panic attack
  • Palpitations, pounding heart or accelerated heart rate.
  • Sweating.
  • Trembling or shaking.
  • Sensations of shortness of breath or smothering.
  • Feeling of choking.
  • Chest pain or discomfort.
  • Nausea or abdominal distress.
  • Feeling dizzy, unsteady, lightheaded or faint.
Dec 21, 2021

What happens if panic disorder goes untreated? ›

People with anxiety, especially when not properly treated, have a higher risk of suicide or self-harm behaviors. People with untreated anxiety may lead a life of isolation. They may use avoidance strategies for fear of an anxiety or panic attack.

What is the best treatment for panic disorder? ›

Antidepressant medications successfully reduce the severity of panic symptoms and eliminate panic attacks. Selective serotonin reuptake inhibitors and tricyclic antidepressants are equally effective in the treatment of panic disorder.

What medications treat panic disorder? ›

FDA-approved medications to treat panic disorder include selective serotonin reuptake inhibitors (SSRIs), extended-release venlafaxine capsules, and benzodiazepines.
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)
Aug 16, 2021

What are the two key components to panic disorder? ›

There are two key components to panic disorder—the attacks are unexpected meaning there is nothing that triggers them, and they are recurrent meaning they occur multiple times.

What is the most common panic disorder? ›

Agoraphobia: Approximately two-thirds of people with panic disorder develop agoraphobia. This anxiety disorder makes you afraid to be in places or situations where a panic attack might happen. The fear can become so extreme that you become too afraid to leave your house.

What is the average age for panic disorder? ›

Symptoms often begin before age 25 but may occur in the mid-30s. Children can also have panic disorder, but it is often not diagnosed until they are older.

Are there different levels of panic disorder? ›

The characteristics of each type are as follows; type I: a single panic attack is the only symptom, type II: only panic attacks occur frequently without any accompanying neurotic or depressive symptoms, type III: a recurrence of panic attacks and the gradual development of neurotic symptoms, such as anticipatory ...

What is the most common comorbidity with panic disorder? ›

Lifetime prevalence rates of major depression in panic disorder may be as high as 50-60%. Other psychiatric disorders that occur comorbidity with panic disorder include schizophrenia, obsessive-compulsive disorder, specific phobias, social phobia, and agoraphobia.

Can you fully recover from panic disorder? ›

Panic disorder is one of the most treatable anxiety disorders. The prevailing treatment is cognitive behavioral therapy (CBT). A new offshoot of CBT, known as Acceptance and Commitment Therapy (ACT), has also been found effective in treating panic disorder.

Can panic disorder ever be cured? ›

People with panic disorder frequently want to know if there is any technique or medication that can completely rid them of symptoms. The truth is that panic disorder can never be entirely cured. 1 However, it can be effectively managed to the point that it no longer significantly impairs your life.

Can you live with panic disorder without medication? ›

Fortunately, you can overcome panic disorder without medication, but don't be reluctant to try it if your symptoms are severe enough.

What is it like living with panic disorder? ›

Panic attack symptoms can vary, but most commonly, a feeling of depersonalization, rapid heartbeat, shakiness and dizziness are part of the experience. Some people who have panic attacks can experience nausea, hot flashes, chills, a sense of dread or doom and numb, tingly feelings in their body.

What are the long term effects of panic disorder? ›

Long-term anxiety and panic attacks can cause your brain to release stress hormones on a regular basis. This can increase the frequency of symptoms, such as headaches, dizziness, and depression.

Is panic disorder psychotic? ›

Panic attacks and psychosis are two different occurrences. Panic attacks occur randomly or due to intense fear, while psychosis is a symptom of an underlying mental health condition. While it's possible they can occur together; they do not have to be directly related to each other.

How hard is it to get disability for panic disorder? ›

Total disability, based only on a Panic Attack diagnosis, can be difficult. However, if your symptoms are severe enough, you may warrant disability benefits based on a diagnosis of Chronic Panic Disorder.

Can you get disability for anxiety and panic disorder if you're unemployed? ›

If symptoms of anxiety are significantly interfering with your daily routine, and you can't work because of anxiety, Social Security can find you disabled, with the proper evidence.

How much money do you get for anxiety disability? ›

Disability benefits for mental health condition also varies depending on if the person on disability receives SSI or SSDI benefits. The average SSI payment for adults in 2021 is $586 per month and the average SSDI payment for adults in 2021 is $1,277.

Is panic disorder neurotic or psychotic? ›

Psychotic disorders, such as schizophrenia and bipolar disorder, can cause delusions, hallucinations, and other symptoms of psychosis. Non-psychotic disorders, which used to be called neuroses, include depressive disorders and anxiety disorders like phobias, panic attacks, and obsessive-compulsive disorder (OCD).

Can you have panic disorder without anxiety? ›

'Non-fearful panic disorder' (NFPD) is a condition that meets DSM III-R criteria for panic disorder but lacks a report of subjective fear or anxiety.

Is F41 0 a billable code? ›

F41. 0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2023 edition of ICD-10-CM F41. 0 became effective on October 1, 2022.

What is the F code for bipolar disorder? ›

F31. 3 (bipolar disorder, current episode depressed, mild, or moderate severity…)

What is the diagnosis for panic disorder? ›

How is panic disorder diagnosed? Your healthcare provider or a mental health professional may diagnose you with panic disorder based on your symptoms. Generally, if you have 4 or more panic attacks and if you are in constant fear of having another, you have panic disorder.

How many panic attacks for panic disorder? ›

What Is Panic Disorder? Panic disorder is when you've had at least two panic attacks (you feel terrified and overwhelmed, even though you're not in any danger) and constantly worry and change your routine to keep from having another one. It's a type of anxiety disorder.

What does anxiety F41 9 mean? ›

Code F41. 9 is the diagnosis code used for Anxiety Disorder, Unspecified. It is a category of psychiatric disorders which are characterized by anxious feelings or fear often accompanied by physical symptoms associated with anxiety.

What is the difference between F41 1 and F41 9? ›

ICD-9 code 300.00 for unspecified anxiety disorder is now F41. 9 for unspecified anxiety disorder, F41. 1 for generalized anxiety disorder, and F41. 8 for other specified anxiety disorders.

What are 3 anxiety disorders in the DSM-5? ›

The five major types of anxiety disorders are:
  • Generalized Anxiety Disorder. ...
  • Obsessive-Compulsive Disorder (OCD) ...
  • Panic Disorder. ...
  • Post-Traumatic Stress Disorder (PTSD) ...
  • Social Phobia (or Social Anxiety Disorder)

Is severe anxiety a permanent disability? ›

Anxiety disorders like OCD, panic disorders, phobias, or PTSD are considered a disability. Therefore, they can qualify for Social Security disability benefits. Individuals must prove that it is so debilitating that it prevents them from working.

What should your anxiety score be? ›

Scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate and severe anxiety, respectively. When used as a screening tool, further evaluation is recommended when the score is 10 or greater. Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for GAD.

What is the average anxiety score? ›

Score interpretation

The following guidelines are recommended for the interpretation of scores: 0–9, normal or no anxiety; 10–18, mild to moderate anxiety; 19–29, moderate to severe anxiety; and 30–63, severe anxiety.

What is the scale of severity for anxiety disorders? ›

The average total score reduces the overall score to a 5-point scale, which allows the clinician to think of the severity of the individual's generalized anxiety disorder in terms of none (0), mild (1), moderate (2), severe (3), or extreme (4).

What is the F code for depression and anxiety? ›

2 Mixed anxiety and depressive disorder.

What is the F code for adjustment disorder with anxiety and depression? ›

Code F43. 23 is the diagnosis code used for Adjustment Disorder (AD) with Mixed Anxiety and Depressed Mood. It is sometimes known as situational depression. It occurs when an individual is unable to adjust to or cope with a particular stress or a major life event.

What is F40 in psychiatry? ›

F40-F48 Neurotic, stress-related and somatoform disorders. F40 Phobic anxiety disorders.


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