Differential clinical features of late-onset panic disorder

Objectives: The aim was to analyse the sociodemographic and clinical charac teristics of panic disorder (PD) in patients with a PD onset after 60 years of age, at two outpatient psychiatric clinics in Barcelona (northeastern S pain). Material and methods: All patients presenting with PD at two outpati ent clinics over a 4-year period were assessed by the same team. Patients w ith PD onset at 60 or after were grouped (late-onset), and compared with th e group with an earlier onset. The instruments administered to the sample w ere: Global Assessment of Functioning scale, Panic-Associated Symptom Scale , Hamilton's Depression and Anxiety Scales and Marks-Matthews' Fear and Pho bia scale. Results: Of 5301 patients attended over a 4-year period, 64 (1.2 %) were PD patients aged 60 or above. Age at PD onset was over 60 in 27 cas es (0.4% of the total population, and 6.1% of all PD patients). The mean ag e in the late-onset group was 67.0 +/- 4.9 years. Late-onset PD patients we re less likely to report family history of PD. They scored lower on most sc ales assessing clinical severity (excepting GAF and agoraphobia scores), an d they exhibited fewer and milder panic symptoms during the attacks. Howeve r, dysthymic disorder, but not major depressive disorder, was more common a mong late-onset PD patients (P < 0.05). Comments: The most notable findings in our late-onset PD subgroup of patients were: lesser severity of the dis order, greater comorbidity with dysthymia, and less family history of PD. P revalence rates of late-onset PD in our sample appeared to be rather high. Physical illness and less severe panic symptoms may contribute to underdiag nosing PD in this particular subpopulation. (C) 2000 Elsevier Science B.V. All rights reserved.