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Aging and Panic Disorder

Phenomenology, Comorbidity, and Risk Factors

Received June 7, 2002; revised July 18, 2002; accepted July 31, 2002. From the Stanford University School of Medicine, Stanford, CA (JIS,SEL), and the National Center for PTSD, Clinical Laboratory and Education Division, VA Palo Alto Health Care System, Palo Alto, CA (JIS,PJS,EBC,SEL). Address correspondence to Javaid I. Sheikh, M.D., Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-5723. e-mail: Sheikh{at}Stanford.edu

Objective: The authors compared young and older adults with panic disorder (PD) to investigate differences in panic-associated phenomenology, psychiatric comorbidity, and risk factors. Method: Patients in the older group (age 60 and above) were further subdivided into early- and late-onset groups and compared. Phenomenology (number of panic symptoms, severity of anxiety, physiological symptoms, panic-associated cognitions, and overall severity of PD); comorbidity (depressive and anxiety disorders); and risk factors (family history of anxiety and life stressors) were assessed in 167 outpatients with PD. Results: Older patients reported fewer panic symptoms, less anxiety and arousal, less severe PD, lower levels of depression, and higher levels of functioning. Furthermore, within the older-patient group, late-onset patients were found to report less distress during panic attacks in relation to body sensations and panic-related cognitions and emotions. Multiple-regression analysis of the entire sample showed that chronological age and age at onset of PD distinctly predicted different domains of panic phenomenology. Conclusion: PD was consistently less severe in older patients across multiple domains, and a later age at onset was associated with less distress due to body sensations, cognitions, and emotions during panic attacks.

Key Words: Panic Disorder • Aging and Anxiety

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