Comprehensive Psychiatry
Volume 43, Issue 1 , Pages 28-36, January 2002

Premorbid conditions and precipitating events in early-onset panic disorder

From the Department of Neurosciences, Psychiatry Section, University of Turin, Italy.

Abstract 

This study investigates differences in premorbid conditions and in the role of triggering events in the onset of early-onset versus adult-onset panic disorder (PD). Two hundred forty-one outpatients with a principal diagnosis of PD (DSM-IV) were evaluated using a semistructured interview to generate axis I and axis II diagnoses according to DSM-IV, and to collect family history of psychiatric disorders and life events. For statistical analysis the sample was subdivided in two groups according to age at onset ([le ]18 years or [gt ]18 years). Early-onset and adult-onset patients with PD do not differ in the severity of the disorder and in the interference with their overall functioning. Early-onset patients have (1) higher familial loading for psychiatric disorders in general and for PD in particular; (2) higher frequency of preceding anxiety disorders, dysmorphophobia, and bulimia nervosa; and (3) higher comorbidity rates for personality disorders and particularly for disorders of the [ldquo ]anxious-fearful[rdquo ] cluster. The data we found on life stress indicate that the environmental factors play a major role in the development and/or in precipitating the onset of adult-onset PD. Our findings suggest that the early-onset form of PD seems to be more characterized by endogenous components compared to the adult-onset form.

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PII: S0010-440X(02)13934-4

doi:10.1053/comp.2002.29844

Comprehensive Psychiatry
Volume 43, Issue 1 , Pages 28-36, January 2002