Panic Disorder Severity Scale (PDSS)

Helps monitor response to treatment by measuring severity of panic symptoms and their occurrence.

Refer to the text below the calculator for more information about this clinician-rated scale and its usage.


The PDSS questionnaire consists of 7 questions developed for measuring the severity of panic disorder and to provide clinicians with a reliable tool for monitoring treatment.

Please note this scale is not a diagnostic tool, but can be used to detect possible symptoms of panic disorder and trigger a formal diagnostic assessment. It is easy to administer (time duration 5-10 min) and so can also be used as a screening tool but due to its sensitivity to change, it is most widely used to monitor response to treatment.


The PDSS was associated with excellent interrater reliability, moderate internal consistency, and positive levels of validity and sensitivity to change.

Each of the 7 items are rated on a 5-point scale (from 0 to 4), so final scores range from 0 to 28, where the higher the score the greater the degree of panic disorder symptom severity. A composite score may also be documented, by dividing the score to 7.


1

How many panic and limited symptoms attacks did you have during the week?

2

If you had any panic attacks during the past week how distressing (uncomfortable, frightening) were they while they were happening?

(If you had more than one, give an average rating. If you didn’t have any panic attacks but did have limited symptom attacks, answer for the limited symptom attacks.)
3

During the past week how much have you worried or felt anxious about when your next panic attack would occur or about fears related to the attacks?

(for example, that they could mean you have physical or mental health problems or could cause you social embarrassment)
4

During the past week were there any places or situations you avoided, or felt afraid of (uncomfortable in, wanted to avoid or leave), because of fear of having a panic attack?

(e.g., public transportation, movie theaters, crowds,bridges, tunnels, shopping malls, being alone) Are there any other situations that you would have avoided or been afraid of if they had come up during the week, for the same reason? If yes to either question, please rate your level of fear and avoidance this past week.
5

During the past week, were there any activities that you avoided, or felt afraid of (uncomfortable doing, wanted to avoid or stop), because they caused physical sensations like those you feel during panic attacks or that you were afraid might trigger a panic attack?

(e.g., physical exertion, sexual relations, taking a hot shower or bath, drinking coffee, watching an exciting or scary movie) Are there any other activities that you would have avoided or been afraid of if they had come up during the week for that reason? If yes to either question, please rate your level of fear and avoidance of those activities this past week.
6

During the past week, how much did the above symptoms altogether interfere with your ability to work or carry out your responsibilities at home?

(panic and limited symptom attacks, worry about attacks, and fear of situations and activities because of attacks) If your work or home responsibilities were less than usual this past week, answer how you think you would have done if the responsibilities had been usual.
7

During the past week how much did panic and limited symptom attacks, worry about attacks and fear of situations and activities because of attacks interfere with your social life?

(If you didn't have many opportunities to socialize this past week, answer how you think you would have done if you did have opportunities.)
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Panic Disorder Severity Scale Explained

The PDSS questionnaire consists of 7 questions developed for measuring the severity of panic disorder and to provide clinicians with a reliable tool for monitoring treatment.

Please note this scale is not a diagnostic tool, but can be used to detect possible symptoms of panic disorder and trigger a formal diagnostic assessment. It is easy to administer (time duration 5-10 min) and so can be used as a screening tool.

The PDSS questions address:

  • Panic frequency;
  • Distress during panic;
  • Panic-focused anticipatory anxiety;
  • Phobic avoidance of situations;
  • Phobic avoidance of physical sensations;
  • Impairment in work functioning;
  • Impairment in social functioning.

To complete the scale, the patient may require further clarification as to what represents panic attacks and limited symptom attacks. For the purpose of the PDSS questionnaire a panic attack is defined as a sudden rush of fear or discomfort accompanied by at least 4 of the symptoms listed below:

  • Rapid or pounding heartbeat;
  • Chest pain or discomfort;
  • Chills or hot flushes;
  • Sweating;
  • Nausea;
  • Fear of losing control or Trembling or shaking;
  • Dizziness or faintness going crazy;
  • Breathlessness;
  • Feelings of unreality;
  • Fear of dying;
  • Feeling of choking;
  • Numbness or tingling.

Episodes like panic attacks but having fewer than 4 of the listed symptoms are called limited symptom attacks.

Each of the 7 items are rated on a 5-point scale (from 0 to 4), so final scores range from 0 to 28, where the higher the score the greater the degree of panic disorder symptom severity. A composite score may also be documented, by dividing the score to 7.

The PDSS (developed in 1997) is best used after diagnosis, as it carries good sensitivity to change and so can help monitor response to treatment. The scale demonstrated adequate internal consistency and reliability, excellent inter-rater reliability, good discriminant validity and sensitivity to change.

 

References

Original reference

Shear MK, Brown TA, Barlow DH, et al. Multicenter collaborative panic disorder severity scale. Am J Psychiatry. 1997;154(11):1571-5.

Other references

Furukawa TA, Katherine shear M, Barlow DH, et al. Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depress Anxiety. 2009; 26(10):922-9.

Houck PR, Spiegel DA, Shear MK, Rucci P. Reliability of the self-report version of the panic disorder severity scale. Depression and anxiety. 2002; 15(4):183-5.


Specialty: Psychiatry

Year Of Study: 1997

Abbreviation: PDSS

Article By: Denise Nedea

Published On: November 3, 2020

Last Checked: November 3, 2020

Next Review: November 3, 2025