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Epidemiology, etiology, panic pathology, predictors
Abstract:
Background: Panic attacks (PA) and panic disorder (PD) as well as
fearful spells only (FS-only, attacks of anxiety not meeting full
criteria for PA or PD) increase the risk for various mental disorders.
It is unclear so far whether FS-only, PA and PD share the same
etiologies and risk factors.
Methods: A representative community sample of adolescents and young
adults (n=3021, aged 14-24 at baseline) was prospectively followed up
over up to 10 years. Panic pathology and putative risk factors were
assessed using the DSM-IV/M-CIDI and its embedded assessment modules and
questionnaires.
Results: In Cox regressions stratified by sex and age, female sex,
parental anxiety and depression, behavioral inhibition, harm avoidance,
lower coping-efficacy and parental rejection predicted the onset of
FS-only, PA and PD (Hazard Ratios 1.2-3.0). Associations with other risk
factors partially differed for FS only, PA and PD and tended to be
stronger for PA and PD than for FS-only.
Limitations: No strictly prospective analytical approach was used. Time
intervals between some risk factors and their retrospective assessment
were relatively long.
Conclusions: Findings suggest that FS-only, PA and PD are etiologically
similar and represent qualitatively equal, albeit differently severe
forms of panic pathology that lie on different points of the same
fear-panic dimension. (C) 2016 Published by Elsevier B.V.
