Encyclopedia of Health and Medicine

P
panic disorder A psychologic condition in which
a person feels extreme fear or panic without
provocation (unlike PHOBIA, which triggers fear
only when facing confrontation with the focus of
the phobia). Such panic attacks are the hallmark
symptoms of panic disorder and often occur without
warning. Symptoms of panic attack can be
severe enough to mimic HEART ATTACK and include
• racing HEART RATE (pulse) and rapid BREATHING or
difficulty breathing
• profuse sweating or cold sweat
• CHEST PAIN
• HEADACHE
• tingling in the toes and fingers
The diagnostic path begins with a prompt
assessment to rule out cardiovascular causes (such
as MITRAL VALVE PROLAPSE, heart attack, or STROKE)
for the symptoms. The most effective treatment
for panic disorder is a combination of BEHAVIOR
MODIFICATION THERAPY and COGNITIVE THERAPY. Relaxation
and stress management techniques, HYP-
NOSIS, and sometimes BIOFEEDBACK can help the
person cope with panic attacks when they occur.
Some people further benefit from short-term
treatment with ANTIANXIETY MEDICATIONS. With
treatment many people are able to overcome
panic disorder.
See also ACUTE STRESS DISORDER; GENERALIZED ANX-
IETY DISORDER (GAD); STRESS AND STRESS MANAGEMENT.
paranoia A person’s unfounded and often disabling
suspicion or fear that others are watching,
following, or in some other fashion persecuting
the person. Paranoia is most commonly a component
of psychotic disorders such as SCHIZOPHRENIA
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though may occur in milder form as a DELUSION
(sometimes called delusional disorder when it persists).
Often it is a family member who brings the
person for treatment because the person’s expressions
or behaviors turn violent.
Paranoia is difficult to treat because the person’s
suspicion prevents him or her from seeking
care or trusting doctors. ANTIPSYCHOTIC MEDICATIONS
and PSYCHOTHERAPY may reduce the intensity of the
paranoia, particularly when other psychiatric
issues are under control. Paranoia may also be a
symptom of degenerative neurologic disorders
such as ALZHEIMER’S DISEASE, ORGANIC BRAIN SYN-
DROME, and BRAIN damage due to TRAUMATIC BRAIN
INJURY (TBI) or STROKE.
See also COGNITIVE FUNCTION AND DYSFUNCTION;
HALLUCINATION; PSYCHOSIS; VIOLENCE.
pervasive developmental disorders (PDD)
AUTISM.
See
phobia An intense, irrational fear that prevents
the person from normal function and interaction.
A phobia such as agoraphobia (fear of public
places) or social phobia (fear of being in groups of
people) may keep the person from participating in
activities vital to the ability to function in the
world. Other phobias are specific and are easier to
avoid, such as arachnophobia (fear of spiders) or
pyrophobia (fear of fire). BEHAVIOR MODIFICATION
THERAPY, which teaches behavior methods for
overcoming the phobia, and COGNITIVE THERAPY,
which teaches understanding of the thinking patterns
that result in phobias, often succeed in managing
long-term phobic symptoms. Gradual,
controlled exposures to the circumstance that
causes the fear effectively cures the phobia for
many people.