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This article presents current research information on the treatment of panic disorder. Specific guidelines are presented to guide the mental health counselor in the delivery of effective psychopharmacological and cognitive-behavioral treatment.
Panic disorder is a major health problem (Barlow, 1997) and one of the most common psychiatric disorders in the United States. Prevalence rates have been estimated from 3 million to 6 million in the general U.S. population (Foote & Seibert, 1999). Prevalence rates in clinical populations have been reported at approximately 10% (Raj, Corvea, & Dagon, 1993).
The essential feature of panic disorder is the reoccurrence of panic attacks. Panic attacks are sudden episodes of intense fear and apprehension. They can occur independent of specific psychiatric or medical diagnoses. Unlike attacks associated with other anxiety disorders, they are not cued by external stimuli. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), at least four of the common symptoms of an attack (e.g., shortness of breath, dizziness, heart palpitations, a fear of dying) must be experienced for a diagnosis of panic disorder. One of the panic attacks must be followed by at least 1 month of persistent concern about having additional attacks (American Psychiatric Association, 1994).
This disorder can wax and wane in severity of symptoms and, if left untreated, become chronic and severely reduce an individual's quality of life with disabling health consequences, including increased risk for severe depression and substance abuse (Agras, 1993). There is an increased likelihood of a suicide attempt for individuals with panic disorder. Up to 20% of individuals with panic disorder attempt suicide during their lifetime (Agras, 1993). Individuals diagnosed with substance abuse, depression, or personality disorders are also at risk for developing chronic panic disorder (Bowden, 1992).
Effective and prompt diagnosis and treatment of panic disorder can contribute to a reduction in the chronicity of this disorder. Effective treatment of panic disorder may also result in the reduction in the development of agoraphobia (Michelson, Marchione, Greenwald, Testa, & Marchione, 1996).
Individuals suffering from symptoms associated with panic disorder may seek relief either from a medical or mental health practitioner. These symptoms may either be treated from a medical, psychiatric, or mental health perspective, including psychiatric medication, medical treatment, or any number of therapies. Outcome...