DIAGNOSTIC PROFILE

Panic Disorder
300.01 (F41.0)

I. INTRODUCTION
A. Client’s Demographics
Dennis is a successful salesman in his early 30s who became divorced after
3 years of marriage. He grows up with very high expectations from his father
since he was a child, although he had a great relationship with his mother.
Despite his father high expectations, Dennis does not show any excellence in
the field that his father expected him to be. He does not excel in academic
either and the continuous demands of his parents make him feel tired of
college then decided to apply for a job instead. Despite being successful in
his line of job, Dennis still anxious with his surroundings.

B. Reason for Referral

The client is presented to a therapist as he experience more panic attack and
was avoidance to deal with crowded places. The attack greatly influence his
social life and made me more anxious with places that he is not familiar with.
His consistent symptoms during the attack are sudden sensation of
smothering, unexplainable intense fear, headaches, and gastrointestinal
problems.

II. JUSTIFICATION
This psychologist in training was able to come up with a diagnosis on Panic
Disorder 300.01 (F41.0). This is due to the fact that diagnostic criteria for this disorder have
been fully satisfied and met. Presented below is the detailed diagnosis.

Diagnostic Criteria Given Facts

CRITERION A CRITERION A

Recurrent unexpected panic attacks. A Dennis feel sudden panic attack in places
panic attack is an abrupt surge of intense he is not familiar with, he often also avoid
fear or intense discomfort that reaches a places that he feel unsafe.
peak within minutes, and during which time
four (or more) of the following symptoms
occur:

Note: The abrupt surge can occur from a

calm state or an anxious state.

1. Palpitations, pounding heart, or 1. Dennis feels a chest pain and started to

accelerated heart rate. feel his heart palpitated that he thought he
was having a heart attack.

2. Sweating. 2. As Dennis entered the classroom for

examinations, his palm greatly sweat
sweating.

3. Trembling or shaking. 3. Dennis does not show any trembling or

shaking symptoms.

4. Sensations of shortness of breath or 4. He feels sudden feeling of smothering

smothering. and unexplained feeling of fear.

5. Feelings of choking. 5. Dennis feels like he was choking in his

throat and chest that he feels like could not
able to breath.

6. Chest pain or discomfort. 6. He feels like there is a sharp pain

through his chest.

7. Nausea or abdominal distress. 7. Dennis was experiencing gastrointestinal

problems. In which he was having a hard
time because of constipation, cramping,
and diarrhea. Occasionally, he also
 experienced severe cramps in his lower
abdominal tract.

8. Feeling dizzy, unsteady, light-headed, or 8. During panic attack Dennis does not feel
faint. any dizziness, unsteady, light-headed, or
faint since he was able to overcome the
attack after several minutes.

9. Chills or heat sensations. 9. Dennis have not describe any chills or

heat sensation in his experience.

10. Paresthesias (numbness or tingling 10. Dennis does not have experience with
sensations). paresthesis.

11. Derealization (feelings of unreality) or 11. He does not have the experienced of
depersonalization (being detached from derealization or depersonalization during
oneself). his in his personal or social history.

12. Fear of losing control or “going crazy.” 12. Dennis does not show any sign of losing
control.

13. Fear of dying. 13. He does not show or mention any

frequent intense fear about dying, although
he avoid places like crowded places and
heavy traffic because of the thoughts of him
could able to find place to relieve himself if
he is having an attack.

Note: Culture-specific symptoms (e.g.,

tinnitus, neck soreness, headache,
uncontrollable screaming or crying) may be
seen. Such symptoms should not count as
one of the four required symptoms

CRITERION B CRITERION B

At least one of the attacks has been After the first panic attack, Dennis relatively
followed by 1 month (or more) of one or more reluctant that usual on going on with
both of the following: social gatherings like accompanying his
wife.

1. Persistent concern or worry about 1. Dennis shows concern on having a panic

additional panic attacks or their attack and that make him more reluctant to
consequences (e.g., losing control, having go a crowded places, he also avoiding
a heart attack, “going crazy”). heavy traffic and was very uncomfortable
with long bridges as he thought of not
having space to pull off his car and
overcome the attack.

2. A significant maladaptive change in 2. Dennis frequently avoiding places with

behavior related to the attacks (e.g., many people and even does want to go with
behaviors designed to avoid having panic his friends to the watch professional football
attacks, such as avoidance of exercise or game, he refusing to outside with Mary as
unfamiliar situations). just wanted to calm his nerves. Additionally,
he always drive at the right side of the lane
even if it was slower, all of this happen to
Dennis after he had an attack.

CRITERION C CRITERION C

The disturbance is not attributable to There is no physiological effects of

the physiological effects of a substance substance or any other medical condition.
(e.g., a drug of abuse, a medication) or
another medical condition (e.g.,
hyperthyroidism, cardiopulmonary
 disorders).

CRITERION D CRITERION D

The disturbance is not better explained There are no signs that Dennis case can
by another mental disorder (e.g., the panic better explained in any mental disorder.
attacks do not occur only in response to
feared social situations, as in social anxiety
disorder; in response to circumscribed
phobic objects or situations, as in specific
phobia; in response to obsessions, as in
obsessive-compulsive disorder; in response
to reminders of traumatic events, as in
posttraumatic stress disorder; or in
response to separation from attachment
figures, as in separation anxiety disorder).

III. TREATMENT RECOMMENDATION

Panic Disorder are often respond to psychotherapy and medication combined, particularly
cognitive behavioral therapy (CBT) is typically effective for treatment of panic disorder. CBT
can help Dennis manage his own thinking, behavior, and even feelings with relation to his
panic attacks. Also, since Dennis has already prescribe with alprazolam (Xanax) before and
ended it because he feel that he becoming more dependent to it and uncomfortable with its
side effects. With a Psychiatrist’s prescription Selective serotonin reuptake inhibitors (SSRIs)
can also be prescribe to Dennis’ condition as SSRI antidepressant have low risks of serious
side effects and this includes fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline
(Zoloft).

Proper knowledge and regular monitoring of the prescription for Dennis’ condition can help
him improve his condition, as well as regular treatment with psychotherapy will also manage
to help him overcome his condition.

IV. COMORBIDITY
Dennis’ diagnosis of Panic Disorder is greatly comorbid with Agoraphobia in which
characterized as having intense fear or anxiety triggered by the real or anticipated exposure
to a wide range of situations, as Dennis experience shows him being avoidance of being in a
crowded places like the first official attack he experience was at the theater and the second
one was when he was driving along with the traffic, being conscious to places that he go as
he describe as if it was like cannot breath. He also conscious when traveling and often take
the right lane of the road as for him, it is easier to pull off.