Giovanna Spantigati

The most recent epidemiological studies show that panic attack disorder (DAP) is widespread among youngsters: 33% are young people between 18 and 25.

It is characterized by the recurrence of acute episodes of anxiety, sudden and brief, significantly different with regard to the intensity and the associated neurodegenerative events. In most patients who have been observed, panic attacks lead to the development of long lasting anxiety episodes with agoraphobic avoidance behavior. Agoraphobia is the fear of places or situations where it can be difficult or embarrassing to escape quickly or to be helped in case of a sudden panic attack. As a result, patients avoid going out alone, going to crowded places, traveling by car or by public transport. During panic attacks the leading episodes are very different in intensity and in clinical manifestations, although it is possible to recognize some fundamental aspects in common: - symptoms show up suddenly, dramatically and often out of the blue - the duration of the crisis is brief and can go from a few seconds to a maximum of half an hour, an hour - anxiety is experienced as not coming from external events and it is accompanied by a painful sense of helplessness, lack of control, fear, threat to one's physical and mental integrity. Then a postcritical phase often follows, consisting of a prolonged period even up to several hours, in which the patient feels fatigue, dizzy, confused head, difficulty walking .

The typical attack symptoms are apprehension, fear, failure, sense of upcoming death, fear of loss of control over one's ideas or actions. To this is associated, in general, to impressive changes in the neurovegetative system such as breathing difficulty, palpitations, chest pain, smothering sensations, dizziness, hot flashes and cold chills, profuse sweating and tremors. These somatic symptoms, mainly cardiopulmonary and vestibular, at the beginning of the disorder lead the patient to consult medical internists, cardiologists, otolaryngologists, or emergency services. (Dr. Salvatore Di Salvo) End of Part Seven.

Giovanna Spantigati