Panic Disorder Severity Scale

What is panic disorder?

Before we discuss the specifics of the Panic Disorder Severity Scale, let's briefly discuss what panic disorder is.

Panic disorder is a type of anxiety disorder, one of the mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders. A person who has panic disorder will, unfortunately, go through episodes where they experience intense fear and discomfort. These episodes are referred to as panic attacks. These attacks are recurring, and the frequency and severity of attacks will depend on how adverse the disorder is. Not only that, but these attacks usually happen out of the blue and often without any triggers. This makes it a horrible ordeal for anyone with the disorder, and they tend to fear having more panic attacks, increasing stress and disrupting their daily lives.

Panic attacks have many similar symptoms as other anxiety disorders. Panic disorder symptoms include the following:

• Feeling detached from reality or a feeling of losing control
• Expecting the worst to happen
• Shortness of breath
• Rapid heartbeats
• Chest pain or chest tightness
• Dizziness
• Trembling
• Profuse sweating

Those with panic disorder will experience these symptoms for several minutes before they gradually disappear.

How to use the Panic Disorder Severity Scale

The Panic Disorder Severity Scale is a clinical tool used to gauge the severity of a patient's panic attacks, specifically those they've experienced recently. The scale begins with a definition of a panic attack and then mentions that at least four symptoms normally accompany a panic attack. The symptoms are listed below the instructions.

The scale also mentions that for an attack to be considered a panic attack, its accompanying symptoms must peak within ten minutes. If the attack is accompanied by less than four of the symptoms listed in the instructions, it is considered a limited-symptom attack.

After reading the instructions, patients or those engaging with the scale will answer seven questions:

1. How many panic and limited-symptom attacks did you have during the week?

2. If you had any panic attacks during the past week, how distressing (uncomfortable, frightening) were they while they were happening? (If you had more than one, give an average rating. If you didn't have any panic attacks but did have limited symptom attacks, the answer for the limited symptom attacks.)

3. During the past week, how much have you worried or felt anxious about when your next panic attack would occur or about fears related to the attacks (for example, that they could mean you have physical or mental health problems or could cause you social embarrassment)?

4. During the past week, were there any places or situations (e.g., public transportation, movie theaters, crowds, bridges, tunnels, shopping malls, being alone) you avoided or felt afraid of (uncomfortable in, wanted to avoid, or left), because of fear of having a panic attack? Are there any other situations that you would have avoided or been afraid of if they had come up during the week, for the same reason? If yes to either question, please rate your level of fear and avoidance this past week.

5. During the past week, were there any activities (e.g., physical exertion, sexual relations, taking a hot shower or bath, drinking coffee, watching an exciting or scary movie) that you avoided, or felt afraid of (uncomfortable doing, wanted to avoid or stop), because they caused physical sensations like those you feel during panic attacks or that you were afraid might trigger a panic attack? Are there any other activities that you would have avoided or been afraid of if they had come up during the week for that reason? If yes to either question, please rate your level of fear and avoidance of those activities this past week.

6. During the past week, how much did the above symptoms altogether (panic and limited symptom attacks, worry about attacks, and fear of situations and activities because of attacks) interfere with your ability to work or carry out your responsibilities at home? (If your work or home responsibilities were less than usual this past week, answer how you think you would have done if the responsibilities had been usual.)

7. During the past week, how much did panic and limited symptom attacks, worry about attacks and fear of situations and activities because of attacks interfere with your social life? (If you didn't have many opportunities to socialize this past week, answer how you think you would have done if you did have opportunities.)

Each item has five answer options, each with corresponding points. The person engaging with the scale simply has to pick the answer that best represents their recent bouts with panic attacks. The maximum score a person can get is 28.

The score serves as an initial indication of whether an individual might be dealing with a panic disorder. This panic disorder assessment provides a snapshot of the person's experiences and symptoms, shedding light on their frequency, intensity, and impact on daily life.

A higher score typically suggests that the respondent frequently experiences severe symptoms associated with panic disorder, such as sudden, intense fear, palpitations, sweating, trembling, or feelings of impending doom. This could indicate a likelihood of panic disorder, but it's crucial to remember that this test is not definitive. If a person's overall panic disorder severity gets a score of 9 or higher, it's best to have them undergo a formal diagnostic assessment.

On the other hand, a lower score indicates fewer or less severe symptoms. While this might suggest that the individual is less likely to have a panic disorder, it does not eliminate the possibility. Other factors, such as the individual's overall mental health, personal circumstances, and physical health, can influence these symptoms.

What are the benefits of using the Panic Disorder Severity Scale?

It can help professionals diagnose panic disorder.

The Panic Disorder Severity Scale is not precisely a diagnostic tool, but it will aid in the process should it be used on a patient who hasn't been diagnosed, especially with unexpected panic attacks. The answers and the score of the patient can be incorporated with the results of other components of a diagnostic evaluation, like blood test results, electrocardiogram results, physical exam results, and information obtained during a psychological evaluation. All of these will be used and cross-checked with the criteria for panic disorder in the most recent edition of the DSM published by the American Psychiatric Association.

It can help guide treatment decisions.

The Panic Disorder Severity Scale aims to examine specific aspects of panic attacks, like how frequently a person tends to experience them, how distressing they are, how often the person fears the next panic attack if they fear going to certain places because of the possibility that they might have a panic attack (anticipatory anxiety), and more. The results can help professionals determine what to focus on when tailor-fitting a treatment plan for the patient.

It can be used to monitor their symptoms over time.

Using the Panic Disorder Severity Scale doesn't have to be a one-time thing. Once the patient has been diagnosed and a treatment plan has been implemented, you can use the Panic Disorder Severity Scale during routine checkups. Your treatment plan should focus on helping the patient manage their symptoms better, so if your plan is working, the raw score of the Panic Disorder Severity Scale should be lower than the first. If not, you probably have to wait a little longer for more favorable results to start showing or make adjustments to the plan and see if the changes do the trick. The scale also works best in conjunction with the Clinical Global Impression Scale (CGI Scale).

It is easy to administer.

This panic disorder scale is designed for convenience and accessibility. It can be taken online in the comfort of one's home or administered by a healthcare provider in a more formal setting. In either case, the test offers a timely and effective way to identify symptoms, making it an essential tool in the early detection and management of panic disorders.