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Depress Anxiety. 2016 Dec;33(12):1155-1177. doi: 10.1002/da.22572. Epub 2016 Oct 24.

Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys.

Author information

1
Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
2
Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
3
National School of Public Health, Management and Professional Development, Bucharest, Romania.
4
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA.
5
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa.
6
School of Public Health, University of Queensland, Herston, QLD, Australia.
7
Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria.
8
Chronic Diseases research Center (CEDOC) and Department of Mental Health, Faculdade de Ciencias Medicas, Universidade Nova de Lisboa, Lisboa, Portugal.
9
Mental Health Services, Ministry of Health Israel, Israel.
10
College of Medicine, Al-Qadisiya University, Al Diwaniya City, Iraq.
11
CIBERSAM, Parc Sanitari Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain.
12
Department of Social Medicine, Federal University of Espirito Santo, Brazil.
13
Instituo Nacional der Psiquiatria, Calzada Mexico Xochimilco, Mexico.
14
School of Psychology, University of Ulster, Londonderry, UK.
15
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
16
Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.
17
Department of Psychiatry, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.
18
Department of Psychology, Hiroshima International University, Hiroshima, Japan.
19
Department of Psychiatry, The Chinese University of Hongkong, Hongkong, China.
20
Institute of Mental Health, Peking University, Beijing, China.
21
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.
22
Institute of Psychiatry and Neurology, Warsaw, Poland.
23
Ecole des Hautes Estudies en Sante Pulbique, Paris Descartes University, Paris, France.
24
Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca. Centro de Investigación Biomédica en Red. Epidemiología y Salud Pública (CIBERESP)-Murcia. Subdirección General de Salud Mental y Asistencia Psiquiátrica. Servicio Murciano de Salud, El Palmar (Murcia), Spain.
25
Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia.
26
National Institute of Health, Peru, Universidad Cayetano Hereidia, St. Martin de Porres, Peru.
27
El Bosque University, Bogota, Colombia.
28
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
29
Trimbos Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
30
Department of Health Care Policy, Harvard University Medical School, Boston, MA, USA.

Abstract

CONTEXT:

The scarcity of cross-national reports and the changes in Diagnostic and Statistical Manual version 5 (DSM-5) regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population.

OBJECTIVE:

To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions.

DESIGN AND SETTING:

Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0.

PARTICIPANTS:

Respondents (n = 142,949) from 25 high, middle, and lower-middle income countries across the world aged 18 years or older.

MAIN OUTCOME MEASURES:

PD and presence of single and recurrent PAs.

RESULTS:

Lifetime prevalence of PAs was 13.2% (SE 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; SE 0.5%), while only 12.8% fulfilled DSM-5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8-2.2) and their course (OR 1.3; 95% CI 1.2-2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9-1.3 and OR 0.7; 95% CI 0.6-0.8). Cross-national lifetime prevalence estimates were 1.7% (SE 0.0%) for PD with a median age of onset of 32 (IQR 20-47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder.

CONCLUSIONS:

We extended previous epidemiological data to a cross-national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology.

KEYWORDS:

anxiety/anxiety disorders; assessment/diagnosis; epidemiology; international; panic attacks/agoraphobia

PMID:
27775828
PMCID:
PMC5143159
DOI:
10.1002/da.22572
[Indexed for MEDLINE]
Free PMC Article

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