Developmental trajectories of anxiety disorders in offspring at high risk for panic disorder and major depression.
The objective of this study was to evaluate the longitudinal course of psychiatric disorders in children of parents with and without panic disorder and major depression as they transition through the period of risk from early to late childhood. Over a 5-year follow-up, we compared the course of psychiatric disorders in offspring of parents with panic disorder, major depression, or neither disorder. Subjects consisted of 233 offspring (from 151 families) with baseline and follow-up assessments. Subjects were comprehensively assessed with structured diagnostic interviews. Anxiety disorders at baseline were used to predict anxiety disorders and major depression at follow-up using stepwise logistic regression. Separation anxiety disorder significantly increased the risk for the subsequent development of specific phobia, agoraphobia, panic disorder, and major depression, even after parental panic and depression were covaried. Agoraphobia significantly increased the risk for subsequent generalized anxiety disorder. These findings suggest that separation anxiety disorder is a major antecedent disorder for the development of panic disorder and a wide range of other psychopathological outcomes, and that it increases the risk for subsequent psychopathology even among children already at high familial risk for anxiety or mood disorder.
Biederman
Joseph
J
Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Boston, MA 02114, USA. jbiederman@partners.org
Petty
Carter R
CR
Hirshfeld-Becker
Dina R
DR
Henin
Aude
A
Faraone
Stephen V
SV
Fraire
Maria
M
Henry
Brianne
B
McQuade
Julia
J
Rosenbaum
Jerrold F
JF
D000293:Adolescent; D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000453:epidemiology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D001010:Anxiety, Separation / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D002675:Child, Preschool; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology*; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors