A nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which statement would the nurse include when describing panic disorder?

Choice A reason: The statement that people with panic attacks have fewer attacks when they also have agoraphobia is clinically incorrect and should not be included in a nursing education presentation on panic disorder. Agoraphobia, which is characterized by intense fear and avoidance of situations from which escape might be difficult or help unavailable during a panic attack, is a common comorbid condition that actually exacerbates the disability associated with panic disorder. DSM-5 recognizes panic disorder and agoraphobia as separate diagnoses that can co-occur, and the presence of agoraphobia typically worsens the clinical course and functional impairment, not reduces attack frequency. Choice B reason: The statement that persons with panic disorder rarely have a comorbid condition of depression is factually inaccurate and therefore inappropriate for inclusion in an educational presentation. Epidemiological and clinical research consistently demonstrates high comorbidity rates between panic disorder and major depressive disorder (MDD), with studies reporting that approximately 50 to 65% of individuals with panic disorder also meet diagnostic criteria for depression at some point in their lifetime. This comorbidity significantly complicates treatment and prognosis, and its acknowledgment is essential to comprehensive psychiatric nursing education. Including an incorrect statement would misinform nursing students. Choice C reason: A clinically accurate and educationally important statement about panic disorder is that individuals experiencing panic attacks frequently misinterpret their somatic symptoms as signs of a myocardial infarction or cardiac emergency. Panic attacks produce intense autonomic nervous system activation, including tachycardia, palpitations, diaphoresis, chest pain, dyspnea, paresthesias, and a sense of impending doom or death. These symptoms closely mimic those of an acute myocardial infarction, leading many clients to present to emergency departments with fear of dying. This misattribution of somatic symptoms to cardiac pathology is a key clinical feature of panic disorder that nursing students must understand to effectively educate and reassure clients. Choice D reason: As noted above, this choice is identical to choice a) and reflects a duplication error in the original question. Both state that people with panic attacks have fewer attacks when they also have agoraphobia. This statement is clinically false. The presence of agoraphobia in a client with panic disorder is associated with greater avoidance behavior, increased functional impairment, and a more chronic clinical course, not a reduction in panic attack frequency. This statement should not be included in any accurate nursing or medical education presentation on panic disorder.