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Am J Psychiatry 1996; 153:376-381
Copyright © 1996 by American Psychiatric Association
Relationship of childhood anxiety to adult panic disorder: correlates and influence on course
MH Pollack, MW Otto, S Sabatino, D Majcher, JJ Worthington, ET McArdle and JF Rosenbaum
Anxiety Disorders Program, Massachusetts General Hospital, Boston, 02114, USA.
OBJECTIVE: This study investigated the correlates of a childhood history of
anxiety disorders in adult patients participating in a longitudinal study
of panic disorder. The authors hypothesized that a history of anxiety
during childhood would be associated with higher rates of comorbid anxiety
and depressive disorders, greater likelihood of anxiety disorders in family
members, and greater chronicity, as reflected by decreased time spent in
remission. METHOD: The presence of a childhood history of anxiety disorders
was assessed by structured interview, and its association with comorbid
anxiety and depressive disorders, family history, and select anxiety
severity variables was examined in a replication sample of 94 patients. The
influence of childhood anxiety on the prospectively ascertained course of
disorder was assessed in a full group of 194 patients. RESULTS: Over half
(54%) of the patients experienced anxiety disorders during childhood. These
patients experienced higher rates of comorbid anxiety and depression,
family history of anxiety, and increased levels of agoraphobia, panic
frequency, and global severity of illness at baseline evaluation. Childhood
anxiety disorders were not independently associated with the number of
months in remission or the severity of illness over time, although a modest
effect for this variable was evident when degree of avoidance and anxiety
sensitivity at baseline were statistically controlled. CONCLUSIONS: Adult
panic patients with a history of anxiety disorders in childhood have
elevated rates of comorbid anxiety and depressive disorders and a tendency
toward increased avoidance, but there was not strong evidence that these
patients respond differently to treatment over time.
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