| Home | Subscribe to the Journal | Sign up for E-Lerts to your inbox |
| This
entire article is available in PDF format to paid subscribers (certain restrictions apply). If you have not already registered for Full Text Access to The Journal, then visit our registration page. |
The Epidemiology of DSM-IV Panic Disorder and Agoraphobia in the United States: Results From the National Epidemiologic Survey on Alcohol and Related ConditionsBridget F. Grant, Ph.D., Ph.D.; Deborah S. Hasin, Ph.D.; Frederick S. Stinson, Ph.D.; Deborah A. Dawson, Ph.D.;Rise B. Goldstein, Ph.D., M.P.H.; Sharon Smith, Ph.D.; Boji Huang, M.D., Ph.D.; and Tulshi D. Saha, Ph.D.Objective: To present nationally representative data on the prevalence, correlates, and comorbidity of DSM-IV panic disorder (PAN), including the differentiation between panic with agoraphobia (PDA) and without agoraphobia (PDWA) and agoraphobia without a history of panic disorder (AG). Method: The data were derived from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). Prevalence, correlates, and comorbidity of PAN, PDA, and PDWA with Axis I and II disorders were determined. Results: Prevalences of 12-month and lifetime PAN were 2.1% and 5.1%. Rates of 12-month and lifetime PDWA were 1.6% and 4.0%, exceeding those of 12-month (0.6%) and lifetime (1.1%) PDA. Rates of 12-month and lifetime AG were extremely low, 0.05% and 0.17%. Being female, Native American, middle-aged, widowed/separated/divorced, and of low income increased risk, while being Asian, Hispanic, or black decreased risk for PAN, PDA, and PDWA. Individuals with PDA were more likely to seek treatment and had earlier ages at onset and first treatment, longer episodes, and more severe disability, impairment, panic symptomatology, and Axis I and II comorbidity than those with PDWA. Conclusion: PDA may be a more severe variant of PAN. Overrepresentation of PDA in treatment settings reflects increased treatment seeking and the severity of PDA relative to PDWA. The very low prevalence of AG leaves open questions about the meaning of the disorder as a distinct clinical entity as defined in the DSM-IV. (J Clin Psychiatry 2006;67:363-374) Received June 2, 2005; accepted Aug. 30, 2005. From the Laboratory of Epidemiology and Biometry, Division of Clinical and Biological Intramural Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Md. (Drs. Grant, Stinson, Dawson, Goldstein, Smith, Huang, and Saha); and the Department of Epidemiology and Psychiatry, Columbia University and New York State Psychiatric Institute, New York, N.Y. (Dr. Hasin). The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), with supplemental support from the National Institute on Drug Abuse. Dr. Hasin acknowledges support from NIAAA grant K05 AA014223, National Institute on Drug Abuse grant R01DA018652, and the New York State Psychiatric Institute. The authors report no other financial affiliation relevant to the subject of this article. The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or the U.S. government. Corresponding author and reprints: Bridget F. Grant, Ph.D., Ph.D., Laboratory of Epidemiology and Biometry, Room 3077, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, M.S. 9304, 5635 Fishers Lane, Bethesda, MD 20892-9304 (e-mail: bgrant@willco.niaaa.nih.gov). |