Differential clinical features of early-onset panic disorder

Background: Although panic disorder (PD) begins typically in adulthood, an earlier onset is not uncommon. Recent studies on early-onset PD indicate th at this subgroup of patients may display distinct clinical characteristics. Objective: To compare a subgroup of early-onset PD patients with the rest of the sample. Method: A consecutive series of 442 patients with PD were in cluded. Family histories were investigated, and clinical assessment employe d the following instruments: Hamilton's scales, Global Functioning Scale, M arks-Mathews' Fears and Phobia Scale, and Panic-Associated Symptom Scale. T he age threshold for 'early-onset' was considered at 18 years. Results: A t otal of 45 patients (10.2%) exhibited early-onset PD, with a mean age at on set of 14.6. They were younger and had a longer duration of illness than la ter-onset patients. No differences were found in severity of panic symptoms , anxiety or depressive symptoms, and social functioning. They had more com orbidity with simple phobia, social phobia, and substance dependence. Rates of PD among first-degree relatives were higher in the early-onset group. C onclusion: Early-onset PD patients displayed a greater familial loading, bu t clinical severity of their panic-agoraphobia symptoms was not higher. Com orbidity was greater with phobic and substance-related disorders. (C) 1999 Elsevier Science B.V. All rights reserved.