title: Risk factors for fearful spells, panic attacks and panic disorder in a community cohort of adolescents and young adults.
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.
  
  
  CONCLUSIONS
  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.
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; Behavioral Epidemiology, Technische Universität Dresden, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Beesdo-Baum
mesh_terms: D000293:Adolescent; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D012307:Risk Factors; D055815:Young Adult
keywords: Epidemiology; Etiology; Panic pathology; Predictors