The Panic Disorder Severity Scale (PDSS) is a clinician rating of severity in people with established panic disorder. Seven ratings, each scored from 0 to 4, can be reported as either a 0-to-4 average or a 0-to-28 sum. The two ranges are equivalent only when all seven ratings are present. The PDSS does not diagnose panic disorder.

Which PDSS this page covers

M. Katherine Shear and colleagues introduced the clinician PDSS in a 1997 multicenter study. It covers panic attacks, anticipatory anxiety, avoidance, and effects on work and social life.

The original study assessed adults who already had a panic disorder diagnosis and no more than mild agoraphobia. A 2001 replication included adults with a wider range of agoraphobia. These were severity studies. Neither shows that the PDSS can make a diagnosis.

This page does not cover the later PDSS Self-Report or the separate ten-item DSM-5-TR panic severity measure. Those forms differ in administration and timeframe. Do not import another form's scoring or missing-data rules into the clinician PDSS.

How the clinician PDSS is administered

The reference period is the past month. The APA PsycTests record describes the clinician PDSS as a scripted interview; a score report should name the exact form and reporting convention.

The seven ratings cover attack-related symptoms, anticipatory anxiety, agoraphobic and bodily-sensation avoidance, and interference with work and social life. The PDSS-SR is a separate patient-reported, past-week form, so a score report should identify which format was used.

How scoring works

Two reporting conventions describe the same seven ratings. Both require a complete form.

Convention	Calculation	Range
Later summed total	Add the seven ratings	0–28
Original composite	Add the seven ratings and divide by seven	0–4

For a complete form, multiply the average by seven to obtain the sum, or divide the sum by seven to obtain the average. A score of 3 therefore has a different meaning on the two ranges.

No PDSS-specific missing-rating rule was found. The sum, average, and conversion all require seven ratings, and a missing value must not be silently scored as zero.

How to interpret a PDSS score

Higher totals reflect greater rated panic-disorder severity. The score combines attack-related symptoms, anticipatory anxiety, avoidance, and interference, so the same total can arise from different clinical patterns.

Agoraphobia affects interpretation. In an analysis of 568 adults from two treatment trials, score ranges differed according to whether agoraphobia was present. The authors proposed a decrease of at least 40% as a treatment-response definition. They proposed a summed score of 5 or lower as remission only when current agoraphobia was absent.

Those definitions describe the trial analysis. They are not universal treatment instructions and do not make the PDSS a diagnostic test. Interpret the result with diagnostic status, agoraphobia, functioning, and the seven individual ratings.

What the result cannot establish

The PDSS cannot establish that the rated experiences are caused by panic disorder or replace medical and diagnostic assessment. It also cannot select treatment or provide a complete safety assessment.

A low total does not rule out serious distress or another condition. NIMH advises clinical evaluation because panic-like symptoms can also occur with other physical or mental health conditions.

Evidence and limitations

The original study found agreement among trained raters and evidence that scores changed when participants improved; because its first sample had limited agoraphobia, the later replication and population-specific interpretation matter.

An independent study of clinician and self-report versions supported the clinician total while finding weaker specificity at the individual-rating level. This cautions against interpreting one rating in isolation.

The current ePROVIDE record identifies the PDSS as an adult clinician-reported outcome and distinguishes the clinician form from later patient-reported and child versions.

Methods must match. Before comparing results, confirm the exact PDSS version, respondent, recall period, reporting range, and missing-data method.

PDSS: Panic Disorder Severity Scale

How the seven-item clinician-administered PDSS is reported as a 0-to-28 sum or 0-to-4 average, what the score means, and which limits matter.