Module 2 :CMN 552 :Module 2 Primary Study Guide: Updated A+ Score Guide

The major subtypes of anxiety disorders in the DSM-5 include panic disorder (with or without agoraphobia), agoraphobia (without a history of panic disorder), specific phobia, social phobia, and generalized anxiety disorder (GAD). Revisions to the classification of anxiety disorders in the DSM-involve removing obsessivecompulsive disorder and posttraumatic disorder have been subsumed under newly created “obsessivecompulsive and related disorders” and “trauma- and stressor-related disorders” categories, respectively. Therefore, both obsessive–compulsive disorder and posttraumatic stress disorder are not considered in this chapter. Other modifications to the proposed DSM-5 anxiety disorders category include the addition of separation anxiety disorder (contained under Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence in the DSMIV), the identification of agoraphobia as a distinct and codable disorder (Diagnosed only with reference to panic disorder in the DSM-IV), minor revisions to criterion language to enhance clarity, objectivity, and consistency across the anxiety disorders, and the relabeling of social phobia as social anxiety disorder (SAD). As such, the term “social phobia” will now be replaced with “social anxiety disorder.” Section 14.2 PANIC DISORDER AND THE PANIC ATTACK SPECIFIER Differential Diagnosis, Etiology, Course, and Treatment Once full criteria have been met, the disorder tends to be chronic, though the course is often fluctuating. Even after treatment to the point of remission, the rate of relapse is high. For example, naturalistic studies often demonstrate a 50 percent relapse rate within 12 months of discontinuing an effective antidepressant. Agoraphobia: Epidemiology Similar to Panic Disorder, more women than men have agoraphobia and the age of onset peaks in the late teens to early twenties. Agoraphobia in the absence of Panic Disorder is considered to be rarer than agoraphobia with comorbid Panic Disorder. However, there is some variability in the prevalence data. The measured prevalence of agoraphobia in specific clinical settings may evolve as the DSM-5’s recognition of agoraphobia without Panic Disorder will spur clinicians to screen and consider the disorder more frequently, even in patients who do not present with panic attacks. Other anxiety disorders are seen alongside agoraphobia in comorbidity rates that often exceed 50 percent. Comorbid depressive disorders are seen in 33 to 52 percent of cases, with some suggestion that the presence of comorbid panic attacks increases the risk of comorbid depressive episodes