{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T01:14:54Z","timestamp":1770513294949,"version":"3.49.0"},"reference-count":118,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T00:00:00Z","timestamp":1520467200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Currently, panic disorder (PD) is considered a mental disorder based on the assumptions that panic attacks (PAs) are \u201cfalse alarms\u201d that arise from abnormally sensitive defense systems in the central nervous system and that PD is treated with therapies specifically acting on anxiety or fear mechanisms. This article aims to propose an alternative perspective based on the results of some experimental studies. Our heuristic proposal suggests not only that PD may be a mental disorder but also that patients with PD have real abnormal body functioning, mainly involving cardiorespiratory and balance systems, leading to a decline in global physical fitness. PAs, as well as physical symptoms or discomfort in some environmental situations, may be \u201creal alarms\u201d signaling that the adaptability resources of an organism are insufficient to respond appropriately to some internal or external changes, thus representing the transient conscious awareness of an imbalance in body functioning. The antipanic properties of several modern treatments for PD may include their beneficial effects on body functions. Although anxiety or fear mechanisms are evidently involved in PD, we hypothesize that a reduction of physical fitness is the \u201cprimum movens\u201d of PD, while anxiety or fear is induced and sustained by repeated signals of impaired body functioning. We propose considering panic in a broader perspective that offers a central role to the body and to contemplate the possible role of somatic treatments in PD.<\/ns4:p>","DOI":"10.12688\/f1000research.12788.1","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T11:35:16Z","timestamp":1520508916000},"page":"294","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Is panic disorder a disorder of physical fitness? A heuristic proposal"],"prefix":"10.12688","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8166-0785","authenticated-orcid":false,"given":"Giampaolo","family":"Perna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Caldirola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2018,3,8]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"169-84","DOI":"10.1002\/mpr.1359","article-title":"Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States.","volume":"21","author":"R Kessler","year":"2012","journal-title":"Int J Methods Psychiatr Res."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"403-15","DOI":"10.1017\/S1461145711000800","article-title":"Evidence-based pharmacotherapy of panic disorder: an update.","volume":"15","author":"N Batelaan","year":"2012","journal-title":"Int J Neuropsychopharmacol."},{"key":"ref-3","article-title":"Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.)","year":"2013"},{"key":"ref-4","article-title":"International Classification of Diseases, Tenth Revision (ICD-10)"},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"623-37","DOI":"10.1016\/j.cpr.2009.08.002","article-title":"Causal modeling of panic disorder theories.","volume":"29","author":"L Fava","year":"2009","journal-title":"Clin Psychol Rev."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"306-17","DOI":"10.1001\/archpsyc.1993.01820160076009","article-title":"False suffocation alarms, spontaneous panics, and related conditions. 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