A comparison of persons with early-versus late-onset panic attacks

Area of Science:

• Psychiatry
• Epidemiology
• Clinical Psychology

Background:

• Panic disorder exhibits a bimodal age at onset, yet limited research compares early-onset and late-onset panic attacks.
• Previous studies suggest late-onset panic may involve fewer symptoms and less avoidance behavior.

Purpose of the Study:

• To compare late-onset panic attacks with early-onset panic attacks regarding comorbidity.
• To assess differences in healthcare utilization between early- and late-onset panic disorder.
• To examine variations in illness behaviors and coping strategies in late-onset versus early-onset panic attacks.

Main Methods:

• A community-based study interviewed randomly selected adults for DSM-III-R panic attacks.
• Subjects with confirmed panic attacks were assessed for panic characteristics, psychiatric comorbidity, symptom perceptions, illness attitudes, coping, and family history.
• Early-onset panic (onset < 50 years) was compared to late-onset panic (onset ≥ 50 years), controlling for age, panic duration, and socioeconomic status using ANCOVA and logistic regression.

Main Results:

• Late-onset panic attacks (N=9) showed reduced mental health sector utilization but increased primary care physician visits for severe panic.
• Patients with late-onset panic reported choking and numbness as more disruptive but depersonalization and sweating as less disruptive.
• Late-onset subjects exhibited fewer comorbid conditions, lower Symptom Checklist-90 scores, reduced hypochondriasis and thanatophobia, and less avoidance or wishful thinking coping.

Conclusions:

• Late-onset panic attacks are associated with decreased mental health service utilization.
• Individuals experiencing late-onset panic attacks present with lower comorbidity levels.
• Late-onset panic disorder correlates with reduced hypochondriasis and enhanced positive coping behaviors.