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Onset and recovery from panic disorder in the Baltimore Epidemiologic Catchment Area follow-up

Published online by Cambridge University Press:  03 January 2018

William W. Eaton ,
James C. Anthony ,
Alan Romanoski ,
Allen Tien ,
Joseph Gallo ,
Guojun Cai ,
Karen Neufeld ,
Thomas Schlaepfer ,
Jonathan Laugharne  and
Li-Shiun Chen
William W. Eaton*
Affiliation:
Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA
James C. Anthony
Affiliation:
Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA
Alan Romanoski
Affiliation:
Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, USA
Allen Tien
Affiliation:
Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA
Joseph Gallo
Affiliation:
Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA
Guojun Cai
Affiliation:
Centre for Health Development, World Health Organization, Kobe City, Japan
Karen Neufeld
Affiliation:
Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, USA
Thomas Schlaepfer
Affiliation:
Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, USA
Jonathan Laugharne
Affiliation:
Geraldton Regional Aboriginal Medical Service, Australia
Li-Shiun Chen
Affiliation:
Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, USA
*
William W. Eaton, Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, 624 N Broadway, Baltimore 21205-1999, USA
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Abstract

Background

The objective is to estimate parameters of the natural history of panic disorder, including its prodrome, incidence, recovery and recurrence.

Method

In 1981 the Baltimore Epidemiologic Catchment Area Study interviewed 3481 individuals probabilistically selected from the household population. During 1993–1996, 1920 of these individuals (73% of survivors) were interviewed again. Baseline and follow-up interviews included the National Institute of Mental Health Diagnostic Interview Schedule. During the follow-up, a subsample was assessed by psychiatrists using the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry (SCAN).

Results

There were 35 new cases of panic disorder in 24 475 person years of exposure, yielding an annual incidence of 1.43 per 1000 per year. Data from the SCAN assessments suggest the incidence estimate is conservative. Incidence is greater in females and declines with age. About one-third of the new cases arise without agoraphobia, but about half have anxiety of some sort present for many years prior to meeting criteria for diagnosis. People with agoraphobia have less intense onsets but slower recoveries than those without agoraphobia.

Conclusions

Panic is heterogeneous in its pattern of onset and recovery. Some of the heterogeneity is associated with the presence of other anxiety over a long period of the life.

Type
Papers
Information
The British Journal of Psychiatry , Volume 173 , Issue 6 , December 1998 , pp. 501 - 507
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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