A Comparison of Persons With Early- Versus Late-Onset Panic Attacks
J Clin Psychiatry 2000;61(6):422-427
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Although some evidence suggests a
bimodal age at onset of panic attacks, the literature comparing
subjects with early versus late onset is limited. Previous work
suggests that people with late-onset panic attacks may have fewer
panic symptoms and exhibit less avoidance. This study sought to
compare late-onset panic attacks and early-onset panic attacks
with regard to (1) comorbidity, (2) health care utilization, and
(3) illness behaviors and coping.
Method: This community-based study involved
interviewing randomly selected adults for the presence of
DSM-III-R panic attacks. If panic attacks were confirmed,
subjects were asked questions concerning panic characteristics,
psychiatric comorbidity, symptom perceptions, illness attitudes,
coping, and family characteristics. Subjects reporting
early-onset panic (panic onset < 50 years of age) were
compared with those reporting late onset (onset >= 50 years of
age). Significant univariate analyses were controlled for
differences in age, panic duration, and socioeconomic status by
using analysis of covariance and logistic regression.
Results: Subjects with late-onset panic attacks
(N = 9) utilized the mental health sector less, but were more
likely to present to family physicians for their worst panic.
Patients with late-onset panic felt that choking and numbness
more strongly disrupted function, but felt less strongly that
either depersonalization or sweating disrupted function. Subjects
with late-onset had fewer comorbid conditions and lower Symptom
Checklist-90 scores. Late-onset subjects also had less
hypochondriasis and thanatophobia while coping less through
avoidance or wishful thinking.
Conclusion: Late-onset panic attacks are
associated with less mental health utilization, lower levels of
comorbidity, less hypochondriasis, and a greater number of
positive coping behaviors.