Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-17T20:12:41.954Z Has data issue: false hasContentIssue false
  • English
  • Français

Panic disorder and subthreshold panic in the UK general population: Epidemiology, comorbidity and functional limitation

Published online by Cambridge University Press:  16 April 2020

P. Skapinakis ,
G. Lewis ,
S. Davies ,
T. Brugha ,
M. Prince  and
N. Singleton
P. Skapinakis*
Affiliation:
Academic Unit of Psychiatry, University of Bristol, Cotham House, Cotham Hill, BS6 6JLBristol, UK Department of Psychiatry, University of Ioannina School of Medicine, Ioannina, Greece
G. Lewis
Affiliation:
Academic Unit of Psychiatry, University of Bristol, Cotham House, Cotham Hill, BS6 6JLBristol, UK
S. Davies
Affiliation:
Academic Unit of Psychiatry, University of Bristol, Cotham House, Cotham Hill, BS6 6JLBristol, UK
T. Brugha
Affiliation:
Division of Psychiatry, University of Leicester, Leicester, UK
M. Prince
Affiliation:
Institute of Psychiatry, King's College, London, UK
N. Singleton
Affiliation:
UK Drug Policy Commission, London, UK
*
*Corresponding author. Tel.: +44 117 9546796; fax: +44 117 9546672. E-mail address: p.skapinakis@bristol.ac.uk (P. Skapinakis).
Get access

Abstract

Objective

The epidemiology of panic disorder has not been investigated in the past in the UK using a nationally representative sample of the population. The aim of the present paper was to examine the epidemiology, comorbidity and functional impairment of subthreshold panic and panic disorder with or without agoraphobia.

Method

We used data from the 2000 Office for National Statistics Psychiatric Morbidity survey (N = 8580). Panic disorder and agoraphobia were assessed with the Revised Clinical Interview Schedule (CIS-R).

Result

The prevalence of panic disorder with or without agoraphobia was 1.70% (95% confidence interval: 1.41–2.03%). Subthreshold panic was more common. Economic inactivity was consistently associated with all syndromes. The comorbidity pattern of the panic syndromes and the associated functional impairment show that panic-related conditions are important public health problems, even in subthreshold status.

Conclusions

The findings show that efforts to reduce the disability associated with psychiatric disorders should include detection and management of panic disorder.

Keywords

Panic disorder, epidemiologyPrevalenceComorbidity
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 6 , September 2011 , pp. 354 - 362
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, et al.Disability and quality of life impact of mental disorders in Europe: results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand 2004;109suppl. 420:38–46.CrossRefGoogle Scholar
Batelaan, N, De Graaf, R, Van Balkom, A, Vollebergh, W, Beekman, AThresholds for health and thresholds for illness: panic disorder versus subthreshold panic disorder. Psychol Med 2007;37:247–256.CrossRefGoogle ScholarPubMed
Bijl, RV, Ravelli, ACurrent and residual functional disability associated with psychopathology: findings from the Netherlands mental health survey and incidence study (NEMESIS). Psychol Med 2000;30:657–668.CrossRefGoogle ScholarPubMed
Bijl, RV, Van Zessen, G, Ravelli, APrevalence of psychiatric disorder in the general population: results of the Netherlands mental health survey and incidence study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol 1998;33:587–595.CrossRefGoogle ScholarPubMed
Brugha, TS, Bebbington, PE, Jenkins, R, Meltzer, H, Taub, NA, Janas, M, et al.Cross validation of a general population survey diagnostic interview: a comparison of CIS-R with SCAN ICD-10 diagnostic categories. Psychol Med 1999;29:1029–1042.CrossRefGoogle ScholarPubMed
Brugha, TS, Bebbington, PE, Jenkins, RA difference that matters: comparisons of structured and semi-structured diagnostic interviews of adults in the general population. Psychol Med 1999;29:1013–1020.CrossRefGoogle Scholar
Brugha, TS, Jenkins, R, Taub, N, Meltzer, H, Bebbington, PEA general population comparison of the composite international diagnostic interview (CIDI) and the schedules for clinical assessment in neuropsychiatry (SCAN). Psychol Med 2001;31:1001–1013.CrossRefGoogle ScholarPubMed
Canino, GJ, Bird, HR, Shrout, PE, Rubio-Stipec, M, Bravo, M, Martinez, R, et al.The prevalence of specific psychiatric disorders in Puerto Rico. Arch Gen Psychiatry 1987;44:727–735.CrossRefGoogle ScholarPubMed
Cramer, V, Torgersen, S, Kringlen, EQuality of life and anxiety disorders: a population study. J Nerv Ment Dis 2005;19:196–202.CrossRefGoogle Scholar
Eaton, WW, Anthony, JC, Romanoski, A, Tien, A, Gallo, J, Cai, G, et al.Onset and recovery from panic disorder in the Baltimore epidemiologic catchment area follow-up. Br J Psychiatry 1998;173:501–517.CrossRefGoogle ScholarPubMed
Fava, GA, Rafanelli, C, Grandi, S, Conti, S, Ruini, C, Mangelli, L, et al.Long-term outcome of panic disorder with agoraphobia treated by exposure. Psychol Med 2001;31:891–898.CrossRefGoogle ScholarPubMed
Gardenswartz, C, Craske, MPrevention of panic disorder. Behav Ther 2001;32:725–737.CrossRefGoogle Scholar
Goodwin, RDAnxiety disorders and the onset of depression among adults in the community. Psychol Med 2002;32:1121–1124.CrossRefGoogle Scholar
Goodwin, RD, Faravelli, C, Rosi, S, Cosci, F, Truglia, E, de Graaf, R, et al.The epidemiology of panic disorder and agoraphobia in Europe. Eur Neuropsychopharmacol 2005;15:435–443.CrossRefGoogle ScholarPubMed
Goodwin, RD, Lieb, R, Hoefler, M, Pfister, H, Bittner, A, Beesdo, K, et al.Panic attack as a risk factor for severe psychopathology. Am J Psychiatry 2004;161:2207–2214.CrossRefGoogle ScholarPubMed
Goodwin, RD, Olfson, MTreatment of panic attack and risk of major depressive disorder in the community. Am J Psychiatry 2001;158:1146–1148.CrossRefGoogle Scholar
Grant, BF, Hasin, DS, Stinson, FS, Dawson, DA, Goldstein, RB, Smith, S, et al.The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 2006;67:363–374.CrossRefGoogle ScholarPubMed
Helzer, JE, Robins, LN, McEvoy, LT, Spitznagel, EL, Stoltzman, RK, Farmer, A, et al.A comparison of clinical and diagnostic interview schedule diagnoses: physician reexamination of lay-interviewed cases in the general population. Arch Gen Psychiatry 1985;42:657–666.CrossRefGoogle ScholarPubMed
Jordanova, V, Wickramesinghe, C, Gerada, C, Prince, MValidation of two survey diagnostic interviews among primary care attendees: a comparison of CIS-R and CIDI with SCAN ICD-10 diagnostic categories. Psychol Med 2004;34:1013–1024.CrossRefGoogle ScholarPubMed
Katon, WJ, Roy-Byrne, P, Russo, J, Cowley, DCost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder. Arch Gen Psychiatry 2002;59:1098–1104.CrossRefGoogle ScholarPubMed
Kessler, RC, Chiu, WT, Jin, R, Ruscio, AM, Shear, K, Walters, EEThe epidemiology of panic attacks, panic disorder, and agoraphobia in the national comorbidity survey replication. Arch Gen Psychiatry 2006;63:415–424.CrossRefGoogle ScholarPubMed
Kessler, RC, Frank, RGThe impact of psychiatric disorders on work loss days. Psychol Med 1997;27:861–873.CrossRefGoogle ScholarPubMed
Kessler, RC, Merikangas, KR, Berglund, P, Eaton, WW, Koretz, DS, Walters, EEMild disorders should not be eliminated from the DSM-V. Arch Gen Psychiatry 2003;60:1117–1122.CrossRefGoogle Scholar
Klerman, GL, Weissman, MM, Ouellette, R, Johnson, J, Greenwald, SPanic attacks in the community. Social morbidity and health care utilization. JAMA 1991;265:742–746.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB, Monahan, PO, Löwe, BAnxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 2007;146:317–325.CrossRefGoogle Scholar
Krueger RF, The structure of common mental disorders. Arch Gen Psychiatry 1999;56:921–926.CrossRefGoogle ScholarPubMed
Lewis, G, Pelosi, AJ, Araya, R, Dunn, GMeasuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychol Med 1992;22:465–486.CrossRefGoogle Scholar
Piccinelli, M, Wilkinson, GGender differences in depression. Critical review. Br J Psychiatry 2000;177:486–492.CrossRefGoogle ScholarPubMed
Pilowsky, DJ, Olfson, M, Gameroff, MJ, Wickramaratne, P, Blanco, C, Feder, A, et al.Panic disorder and suicidal ideation in primary care. Depress Anxiety 2006;23:11–16.CrossRefGoogle ScholarPubMed
Pirkola, SP, Isometsa, E, Suvisaari, J, Aro, H, Joukamaa, M, Poikolainen, K, et al.DSM-IV mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population. Results from the health 2000 study. Soc Psychiatry Psychiatr Epidemiol 2005;40:1–10.CrossRefGoogle ScholarPubMed
Rose, G, Barker, DJEpidemiology for the uninitiated. What is a case? Dichotomy or continuum? Br Med J 1978;2(6141):873–874.CrossRefGoogle ScholarPubMed
Roy-Byrne, PP, Stang, P, Wittchen, HU, Ustun, B, Walters, EE, Kessler, RCLifetime panic-depression comorbidity in the national comorbidity survey. Association with symptoms, impairment, course and help-seeking. Br J Psychiatry 2000;176:229–235.CrossRefGoogle ScholarPubMed
Saunders, JB, Aasland, OG, Babor, TF, de la Fuente, JR, Grant, MDevelopment of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction 1993;88:791–804.CrossRefGoogle Scholar
Simon, GE, VonKorff, MRecall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiol Rev 1995;17:221–227.CrossRefGoogle ScholarPubMed
Singleton, N, Bumpstead, R, O’Brien, M, Lee, A, Meltzer, HPsychiatric morbidity among adults living in private households. The Stationery Office; 2001Google Scholar
Stein, MB, Roy-Byrne, PP, McQuaid, JR, Laffaye, C, Russo, J, McCahill, ME, et al.Development of a brief diagnostic screen for panic disorder in primary care. Psychosom Med 1999;61:359–364.CrossRefGoogle ScholarPubMed
Vollebergh, WA, Iedema, MJ, Bijl, RV, de Graaf, R, Smit, F, Ormel, JThe structure and stability of common mental disorders: the NEMESIS study. Arch Gen Psychiatry 2001;58:597–603.CrossRefGoogle ScholarPubMed
VonKorff, MR, Eaton, WW, Keyl, PMThe epidemiology of panic attacks and panic disorder. Results of three community surveys. Am J Epidemiol 1985;122:970–981.CrossRefGoogle Scholar
Ware, J Jr., Kosinski, M, Keller, SDA 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220–233.CrossRefGoogle ScholarPubMed
Weissman, MM, Klerman, GL, Markowitz, JS, Ouellette, RSuicidal ideation and suicide attempts in panic disorder and attacks. N Engl J Med 1989;321:1209–1214.CrossRefGoogle ScholarPubMed
Weissman, MM, Myers, JK, Harding, PSPsychiatric disorders in a U.S. urban community: 1975–1976. Am J Psychiatry 1978;135:459–462.Google Scholar
Wittchen, HU, Essau, CAEpidemiology of panic disorder: progress and unresolved issues. J Psychiatr Res 1993;27suppl. 1:47–68.CrossRefGoogle ScholarPubMed
Wittchen, HU, Reed, V, Kessler, RCThe relationship of agoraphobia and panic in a community sample of adolescents and young adults. Arch Gen Psychiatry 1998;55:1017–1024.CrossRefGoogle Scholar
Wittchen, HUReliability and validity studies of the WHO composite international diagnostic interview (CIDI): a critical review. J Psychiatr Res 1994;28:57–84.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.