Other Specified Anxiety Disorders

Primer

Other Specified Anxiety Disorders is a category of DSM-5 diagnoses that applies to individuals who have symptoms characteristic of an anxiety disorder but do not meet the full criteria for any of them. This category in anxiety disorders also includes disorders with cultural components. “Other Specified” diagnoses are not limited to these disorders and are used throughout the DSM-5 to capture presentations where individuals have significant clinical impairment but do not meet standard criteria.[1]

Diagnoses

Examples of presentations that can be specified using the “other specified” designation include the following;

  1. Limited-symptom attacks
  2. Generalized anxiety not occurring more days than not
  3. Khyâl cap (wind attacks)
  4. Ataque de nervios (attack of nerves)

Cultural

  • Panic attacks can have various cultural interpretations and is linked to various cultural syndromes.[2] Having an understanding of the cultural concepts of disease and mental disorders is important when assessing panic attack symptoms in a cultural context.[3]

Ataque de Nervios ("Attack of Nerves")

  • In Hispanic individuals, ataque de nervios (“attack of nerves”) is a cultural syndrome used frequently to describe symptoms of intense emotional upset including acute anxiety, anger, or grief, screaming and shouting uncontrollably, attacks of crying, trembling, feeling of heat in the chest rising into the head, and verbal and physical aggression.[4] Some individuals may even report dissociative episodes.

Khyâl Attacks (Khyâl Cap) "Wind Attacks"

  • In Cambodians, “Khyâl attacks” (khyâl cap) or “wind attacks” include palpitations, shortness of breath, dizziness, and cold extremities. Individuals also have other symptoms of anxiety and autonomic arousal such as neck soreness and tinnitus.[5]

References

1) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
2) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
3) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
4) Liebowitz, M. R., Salmán, E., Jusino, C. M., Garfinkel, R., Street, L., Cárdenas, D. L., ... & Davies, S. (1994). Ataque de nervios and panic disorder. The American journal of psychiatry.
5) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.