PubMed · 6849450
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1983. Panic attacks and depression.. https://doi.org/10.1176/ajp.140.2.aj1402262
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A representative sample of 826 eight-year-old second-graders in Dresden was examined in a two-stage procedure to ascertain the 6-month prevalence of DSM-IV anxiety disorders. Particular care was taken to assess panic disorder. The eight-year-olds had already been interviewed personally in a screening session and in 230 children an individual diagnostic examination with a structured diagnostic interview was carried out. The total prevalence of anxiety disorder was 9.5%. No case of either panic disorder or agoraphobia was found. For the diagnosis of agoraphobia the DSM-IV diagnostic criterion was lacking in which situations typical to agoraphobia are feared or avoided because escape would be difficult or it would be difficult to reach help. Eight-year-olds do not forge this cognitive link. In agoraphobic situations 2.5% of the children (almost exclusively, girls) suffer from a specific phobia. The prevalence of anxiety disorders is markedly higher among girls than in boys.
In the literature on the aetiology of panic disorder, the separation-anxiety-hypothesis is discussed, in which separation anxiety disorder is conceived as a precursor of panic disorder. Using the representative sample of the Dresden Child Anxiety Study (DKAS) we examined weather agoraphobic and separation anxiety symptoms do already co-occur systematically in eight-year-olds. After N = 826 children had been screened, N = 230 took part in an individual diagnostic interview. With a total prevalence of 9.5% for all anxiety disorders, the prevalence rate for separation anxiety amounted to 2.8%. Another 2.5% of the children (almost exclusively girls) received a diagnosis of specific phobia in agoraphobic situations. Separation anxiety, social anxiety, agoraphobic anxiety and panic anxiety were assessed on a dimensional level, as well. However, no specific pattern of co-morbidity could be found in terms of an increased frequency of agoraphobic fears and separation anxiety occurring simultaneously. The symptom profiles of children with separation anxiety and those with agoraphobic anxieties differed considerably. Children currently living in a separation situation do not exhibit separation anxiety or agoraphobia more frequently than the rest of the children.
The coincidence between panic disorder and depression is a well known phenomenon. However, only few studies investigated the coincidence of panic disorder with schizophrenia. This may in part be explained by the fact that both positive and negative symptoms of schizophrenia may mask the clinical symptoms of a panic disorder. We report on a female patient suffering both from agoraphobia with panic disorder and paranoid schizophrenia according to ICD-10. The productive psychotic symptoms responded well to treatment with a low dose of zotepine, whereas the panic disorder was effectively treated with a combined therapy with imipramine and cognitive behavioral therapy. Although it has to be questioned whether the coincidence between panic disorder and schizophrenia reflects two different diagnostic entities, the occurrence of symptoms of a panic disorder in schizophrenia deserve further attention because these may be treated efficiently by a specific pharmacotherapy and psychotherapy.