Epidemiology of Panic Disorder

Abstract

The prevalence of panic disorder in the general population is 2,3% over a person's whole life, and 0,5-1% per year. International studies have yielded more widely varying estimates of the prevalence of panic attacks (4-12%). The proportion of patients consulting their doctors for panic disorder is also highly variable; the frequency is a function of the medical specialty (being highly represented in cardiology and the emergency services). In psychiatry, panic disorder represents the main diagnosis in one patient out of 10 or 20. Panic disorder is more common in women than men, and in young or middle-aged subjects and those living alone (separated, widowed or divorced). In socio-economic terms, it is the socio-educational level rather than income or profession that appears to be the determining factor. Lastly, residence (urban/rural) and the fact of belonging to a particular socio-cultural group seem to play little part. As with many mental disorders, two predisposing factors have been found to operate: a genetic element, as shown by family and twin studies, and an element relating to psychoaffective development (traumatic events in childhood, separation anguish, etc.). Panic disorder is commonly associated as a comorbid trait with other neurotic and anxiety disorders, depression, alcoholism and drug abuse. These associations represent poor prognostic factors associated with chronicity, attempted suicide and social handicap. Prospective studies of overall outcome have shown complete remission rates of 10-20% at 3 or 5 years. However, if the occasional occurrence of a few panic attacks is regarded as acceptable, the prognosis can be regarded as good for two-thirds of affected subjects.