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Chapter V

Other anxiety disorders - F41


Disorders in which manifestation of anxiety is the major symptom and is not restricted to any particular environmental situation. Depressive and obsessional symptoms, and even some elements of phobic anxiety, may also be present, provided that they are clearly secondary or less severe.
F41.0 Panic disorder [episodic paroxysmal anxiety]
The essential feature is recurrent attacks of severe anxiety (panic), which are not restricted to any particular situation or set of circumstances and are therefore unpredictable. As with other anxiety disorders, the dominant symptoms include sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealization). There is often also a secondary fear of dying, losing control, or going mad. Panic disorder should not be given as the main diagnosis if the patient has a depressive disorder at the time the attacks start; in these circumstances the panic attacks are probably secondary to depression.
Panic:
  • attack
  • state
      Excludes:
    • panic disorder with agoraphobia ( F40.0 )
  • F41.1 Generalized anxiety disorder
    Anxiety that is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is "free-floating"). The dominant symptoms are variable but include complaints of persistent nervousness, trembling, muscular tensions, sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort. Fears that the patient or a relative will shortly become ill or have an accident are often expressed.
    Anxiety:
  • neurosis
  • reaction
  • state
      Excludes:
    • neurasthenia ( F48.0 )
  • F41.2 Mixed anxiety and depressive disorder
    This category should be used when symptoms of anxiety and depression are both present, but neither is clearly predominant, and neither type of symptom is present to the extent that justifies a diagnosis if considered separately. When both anxiety and depressive symptoms are present and severe enough to justify individual diagnoses, both diagnoses should be recorded and this category should not be used.
    Anxiety depression (mild or not persistent)
    F41.3 Other mixed anxiety disorders
    Symptoms of anxiety mixed with features of other disorders in F42-F48. Neither type of symptom is severe enough to justify a diagnosis if considered separately.
    F41.8 Other specified anxiety disorders
    Anxiety hysteria
    F41.9 Anxiety disorder, unspecified
    Anxiety NOS


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