title: Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community study.
abstract: BACKGROUND
  Although fearful spells (FS) and panic attacks (PA) increase the risk for various mental disorders, few studies have examined whether help-seeking in those with FS/PA attenuates the risk for incident psychopathology.
  
  
  METHODS
  A community sample of adolescents and young adults (N=2978, aged 14-24 at baseline) was followed up in up to 3 assessment waves over 10 years. FS, PA, psychopathology, and help-seeking were assessed using the DSM-IV/M-CIDI. Logistic regressions with interaction terms (adjusted for sex and age) were used to test interactions between FS/PA and help-seeking at baseline on predicting incident psychopathology at follow-up. Cases with panic disorder (PD) at baseline were excluded from all analyses.
  
  
  RESULTS
  FS/PA at baseline predicted the onset of any disorder, any anxiety disorder, PD, agoraphobia, generalized anxiety disorder, social phobia, and depression at follow-up (Odds Ratios, OR 1.62-5.80). FS/PA and help-seeking at baseline interacted on predicting incident PD (OR=0.09) and depression (OR=0.22) at follow-up in a way that FS/PA only predicted the respective disorders in individuals not seeking help at baseline. In those with FS/PA, a higher number of panic symptoms interacted with help-seeking on predicting incident PD (OR=0.63) in a way that a higher number of panic symptoms only increased the risk for PD in those without help-seeking at baseline.
  
  
  CONCLUSIONS
  Help-seeking at baseline was not restricted to panic-specific interventions, but included treatment due to other psychological problems as well.
  
  
  CONCLUSIONS
  Findings suggest that early help-seeking might modify psychopathology trajectories and prevent incident disorders in high-risk individuals with FS/PA.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany. Electronic address: eva.asselmann@tu-dresden.de.
authors.forename: Eva
authors.initials: E
authors.lastname: Asselmann
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Switzerland.
authors.forename: Roselind
authors.initials: R
authors.lastname: Lieb
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo-Baum
mesh_terms: D000293:Adolescent; D000379:Agoraphobia / Q000523:psychology; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control; D005239:Fear; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016584:Panic Disorder / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D010358:Patient Participation; D010698:Phobic Disorders / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D011599:Psychopathology; D012307:Risk Factors; D055815:Young Adult
keywords: Anxiety; Depression; Fearful spell; Help-seeking; Panic attack; Prospective-longitudinal