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 with-
out warning. Symptoms of panic attack can be
severe enough to mimic HEART ATTACKand include

• racing HEART RATE(pulse) and rapid BREATHINGor
  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, orSTROKE)
for the symptoms. The most effective treatment
for panic disorder is a combination of BEHAVIOR
MODIFICATION THERAPYand COGNITIVE THERAPY. Relax-
ation and stress management techniques, HYP-
NOSIS, and sometimes BIOFEEDBACKcan 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 dis-
abling suspicion or fear that others are watching,
following, or in some other fashion persecuting
the person. Paranoia is most commonly a compo-
nent of psychotic disorders such as SCHIZOPHRENIA

though may occur in milder form as a DELUSION

(sometimes called delusional disorder when it per-

sists). Often it is a family member who brings the

person for treatment because the person’s expres-

sions or behaviors turn violent.

Paranoia is difficult to treat because the per-

son’s suspicion prevents him or her from seeking

care or trusting doctors. ANTIPSYCHOTIC MEDICATIONS

and PSYCHOTHERAPYmay 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 BRAINdamage due to TRAUMATIC BRAIN

INJURY(TBI) or STROKE.

See also COGNITIVE FUNCTION AND DYSFUNCTION;

HALLUCINATION; PSYCHOSIS; VIOLENCE.

pervasive developmental disorders (PDD) See

AUTISM.

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 pat-

terns that result in phobias, often succeed in man-

aging long-term phobic symptoms. Gradual,

controlled exposures to the circumstance that

causes the fear effectively cures the phobia for

many people.

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