Premorbid conditions and precipitating events in early-onset panic disorder.
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 (< or =18 years or >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 "anxious-fearful" 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.
Venturello
Sara
S
Department of Neurosciences, Psychiatry Section, University of Turin, Via Cherasco 11, 10126 Turin, Italy.
Barzega
Giulio
G
Maina
Giuseppe
G
Bogetto
Filippo
F
D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D015897:Comorbidity; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D016017:Odds Ratio; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D012307:Risk Factors; D012959:Socioeconomic Factors