I. OVERVIEW: Panic disorder (PD), also known as acute anxiety disorder, is characterized by recurrent, sudden, unpredictable, and intense panic experiences, usually lasting 5-20 minutes, accompanied by a sense of near-death or loss of control, with patients often experiencing fear and terror on the verge of a catastrophic outcome. The attacks are accompanied by very specific and intense cardiac and neurologic symptoms that are very worrying for the patient. And the persistent anxiety and preoccupation with the recurrence of the attack over a period of 1 month can produce certain behavioral changes in the patient, with some people being unable to work or study normally, and some people avoiding certain places where they cannot easily escape or ask for help, or not wanting to be alone, and so on. Panic disorder is a chronic relapsing disorder accompanied by significant functional impairment. With a prevalence of about 3%, it is a disorder with a high rate of disability, a high rate of co-morbidity with alcohol abuse, somatic and other mental illnesses, and a 30% rate of co-morbidity with depressive disorders, which is even more unfavorable to the prognosis. The risk of suicidal ideation and suicide attempts in patients with this disease is twice as high as in patients with attempted mental illness and almost 20 times higher than in those without mental illness. Clinical manifestations: panic disorder is characterized by the unpredictability and suddenness of the attack, the degree of reaction is strong, the patient often experience the fear and horror of the end of the catastrophic end, and the termination is also rapid. Its clinical manifestations are characterized as follows: (1) Panic attack: a sudden experience of panic, accompanied by a sense of near death or a sense of loss of control, accompanied by severe symptoms of autonomic dysfunction, such as chest tightness, tachycardia, irregular heartbeat, dyspnea or hyperventilation, headache, dizziness, numbness of the limbs and sensory abnormalities, sweating, throbbing, shivering or weakness of the whole body, etc. During the attack, the patient is always conscious and highly alert. Always conscious and highly alert during an attack. Usually the onset is rapid and the termination is also rapid, usually peaking within 10 minutes and rarely exceeding 1 hour. (2) Anticipatory anxiety: the interval of the attack is still palpitating, worrying about having another attack and being anxious, and there can also be frequent panic, chest tightness, muscle tension, and so on. (3) Help and avoidance: 60% of the patients are afraid to go out alone, to crowded occasions, to take the bus, to the highway, etc. due to the fear of not being able to get help at the onset of the attack, or else they are anxious and uncomfortable. (4) Many patients develop depressive symptoms after repeated medical treatment or poor self-adjustment, and 7% of patients have a history of suicide attempts. (5) Some patients form alcohol or valium drug abuse to relieve symptoms. Treatment: 1, treatment goal: reduce the frequency and severity of panic attacks, relieve anticipatory anxiety, fear avoidance, treatment-related depressive symptoms, so that patients achieve clinical recovery; minimize the co-morbidity rate, reduce the disability rate and the suicide rate; restore the patient’s functioning, improve the quality of life. 2.Treatment principles: comprehensive treatment (assessment-based medication, psychotherapy, family social intervention and physical therapy, etc.); full course of treatment (acute, consolidation and maintenance periods); individualized treatment. 3, treatment strategy: (1) early diagnosis and early treatment: panic disorder patients may have 2 ways of consultation, one is to consult a comprehensive department, such as respiratory (suspected asthma), cardiovascular (suspected heart disease), endocrinology, neurology, etc.; the other is to consult the emergency room. Patients often arrive at the hospital after the symptoms have been partially or completely relieved, the physician detailed examination to rule out heart disease and other disorders referred to the mental health department to make a diagnosis and early treatment. (2) Choose the appropriate place of treatment: patients are often combined with depressive symptoms, there is a high risk of suicide, family members should attach great importance to hospitalization, if necessary, such as the combination of substance dependence also need to standardize detoxification treatment. (3) Course of treatment: Acute treatment usually lasts 4-12 weeks, and patients enter the consolidation phase of treatment, which lasts at least 9-12 months, after basically achieving clinical recovery. If the disease does not rekindle, enter the maintenance period, begin to closely observe the changes in the condition of the basis of gradual reduction of drugs, if the relapse should be immediately restarted drug therapy. (1) Although panic disorder is not a serious mental illness, standardized comprehensive treatment is more effective, but patients generally have poor treatment compliance, sensitivity to adverse reactions, long-term recurrent episodes of brain function and brain structure abnormalities, social life is seriously impaired, repeated visits to the doctor to consume a lot of medical resources and increase the economic burden on the family phenomenon. Therefore, patients and their families should pay special attention to the following: take medication on time every day; some drugs may take effect only after a few weeks (non-benzodiazepines); continue to take medication after symptoms improve; do not reduce or stop medication on your own; consult a doctor in time for guidance on how to deal with adverse reactions and other related problems; make reasonable arrangements in time for daily activities or sports you like to do; and try to live, study, and work normally as much as possible. (2) Prohibit or be cautious of using alcohol and diet drugs, other psychoactive substances during the medication, and reduce smoking. (3)Please be sure to use under the guidance of a doctor when co-morbidities exist that require the combined use of multiple medications. (4) Benzodiazepines (Valium) have a faster onset of action than antidepressants (which have an anxiolytic effect), and their early use can help patients improve sleep and reduce intolerance to antidepressants at an early stage. However, long-term use of these drugs is not recommended. (5) Panic disorder is associated with psychosocial factors, brain structure and function abnormalities, genetics, growth environment, repeated negative life events and catastrophic cognition and other factors, so it requires comprehensive treatment, such as assessment-based medication, cognitive-behavioral psychotherapy, physical therapy, family and social interventions, cultural and sports activities, etc., and medication alone can not “get rid of the root cause” of many patients. Many patients cannot be “cured” by medication alone.