The panic-agoraphobic spectrum

Categorical classifications of mental disorders do not take into account th e subthreshold, atypical and often enduring symptoms that accompany the cor e manifestations of full-blown mental disorders. However, this often neglec ted spectrum of symptoms may be as distressing and debilitating as the full -blown disorder and may have unrecognized importance in treatment selection and response. To this end, a spectrum approach to mental disorders, such a s bipolar, obsessive-compulsive, eating, and panic disorder has been develo ped, which has been extensively used and proven effective in clinical pract ice. The need for a systematic identification and assessment of a broad arr ay of symptoms and behavioural features led, as a first step, to the concep tualization of the panic-agoraphobic spectrum model and to the development of a structured interview (SCI-PAS). This model has been constructed by ide ntifying different psychopathological and clinical domains incorporating an d extending Panic Disorder as described in DSM-IV. The rationale, clinical usefulness, and heuristic significance of the panic-agoraphobic spectrum mo del will be discussed. Copyright (C) 1999 John Wiley & Sons, Ltd.