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ICD-10 - Other Anxiety Disorders

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[From World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Copyright, World Health Organization, Geneva, 1993.] ...

Panic disorder [episodic paroxysmal anxiety]
  1. The individual experiences recurrent panic attacks that are not consistently associated with a specific situation or object and that often occur spontaneously (i.e., the episodes are unpredictable). The panic attacks are not associated with marked exertion or with exposure to dangerous or life-threatening situations.
  2. A panic attack is characterized by all of the following:
    1. it is a discrete episode of intense fear of discomfort;
    2. it starts abruptly;
    3. it reaches a maximum within a few minutes and lasts at least some minutes;
    4. at least four of the symptoms listed below must be present, one of which must be from items (a) to (d):
      Autonomic arousal symptoms
      1. palpitations or pounding heart, or accelerated heart rate;
      2. sweating;
      3. trembling or shaking;
      4. dry mouth (not due to medication or dehydration);
      Symptoms involving chest and abdomen
      1. difficulty in breathing;
      2. feeling of choking;
      3. chest pain or discomfort;
      4. nausea or abdominal distress (e.g., churning in stomach);
      Symptoms involving mental state
      1. feeling dizzy, unsteady, faint, or light-headed;
      2. feeling that objects are unreal (derealization), or that the self is distant or “not really here” (depersonalization);
      3. fear of losing control, “going crazy,” or passing out;
      4. fear of dying;
      General symptoms
      1. hot flushes or cold chills;
      2. numbness or tingling sensations.
  3. Most commonly used exclusion clause. Panic attccks are not due to a physical disorder, organic mental disorder, or other mental disorders, such as schizophrenia and related disorders, mood [affective] disorders, or somatoform disorders.
The range of individual variation in both content and severity is so great that two grades, moderate and severe, may be specified, if desired, with a fifth character.
Panic disorder, moderate
At least four panic attacks in a 4-week period.
Panic disorder, severe
At least four panic attacks per week over a 4-week period.
Generalized anxiety disorder
Note. In children and adolescents the range of complaints by which the general anxiety is manifest is often more limited than in adults, and the specific symptoms of autonomic arousal are often less prominent. For these individuals, an alternative set of criteria is provided for use (in generalized anxiety disorder of childhood) if preferred.
  1. There must have been a period of at least 6 months with prominent tension, worry, and feelings of apprehension about everyday events and problems.
  2. At least four of the symptoms listed below must be present, at least one of which must be from items (1) to (4):
    Autonomic arousal symptoms
    1. palpitations or pounding heart, or accelerated heart rate;
    2. sweating;
    3. trembling or shaking;
    4. dry mouth (not due to medication or dehydration);
    Symptoms involving chest and abdomen
    1. difficulty in breathing;
    2. feeling of choking;
    3. chest pain or discomfort;
    4. nausea or abdominal distress (e.g., churning in stomach);
    Symptoms involving mental state
    1. feeling dizzy, unsteady, faint, or light-headed;
    2. feelings that objects are unreal (derealization), or that the self is distant or “not really here” (depersonalization);
    3. fear of losing control, “going crazy,” or passing out;
    4. fear of dying;
    General symptoms
    1. hot flushes or cold chills;
    2. numbness or tingling sensations;
    Symptoms of tension
    1. muscle tension or aches and pains;
    2. restlessness and inability to relax;
    3. feeling keyed up, on edge, or mentally tense;
    4. a sensation of a lump in the throat, or difficulty in swallowing;
    Other nonspecific symptoms
    1. exaggerated response to minor surprise or being startled;
    2. difficulty in concentrating, or mind “going blank,” because of worrying or anxiety;
    3. persistent irritability;
    4. difficulty in getting to sleep because of worrying.
  3. The disorder does not meet the criteria for panic disorder, phobic anxiety disorders, obsessive-compulsive disorder, or hypochondriacal disorder.
  4. Most commonly used exclusion clause. The anxiety disorder is not due to a physical disorder, such as hyperthyroidism, an organic mental disorder, or a psychoactive substance-related disorder, such as excess consumption of amphetaminelike substances or withdrawal from benzodiazepines.
Mixed anxiety and depressive disorder
There are so many possible combinations of comparatively mild symptoms for these disorders that specific criteria are not given other than those already in Clinical Descriptions and Diagnostic Guidelines. It is suggested that researchers wishing to study patients with these disorders should arrive at their own criteria within the guidelines, depending upon the setting and purpose of their studies.
Other mixed anxiety disorders
Other specified anxiety disorders
Anxiety disorder, unspecified



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