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Panic Disorder |
Overcoming Anxiety (Home) > Panic Disorder > Epidemiology EpidemiologyThe rates of panic disorders are consistent across diverse countries. The annual rate of panic disorder ranged from 1.7 per 100 in West Germany to 0.2 per 100 in Taiwan, a country that has low rates of all psychiatric disorders. The lifetime ranged from 3.8 per 100 in Holland to 0.4 per 100 in Taiwan. These lifetime rates are twice as high as the rate in the Epidemiologic Catchment Area (ECA) (1.7 per 100). These differences may be caused by a period effect with increasing rates between the ECA conducted in the early 1980s and this study conducted in the early 1990s. It could also be caused by differences in the DSM-III and DSM-III-R criteria for panic disorder; DSM III requires three panic attacks in a three-week period, while the DSM- III-R criteria used in the latter study are broader than DSM-III criteria because they include persistent worry about having another attack. DSM-III-R also includes an additional symptom (nausea or abdominal distress) as one of the criteria. The lifetime prevalence of panic disorder with agoraphobia is around 1.5%. Numbers of years of education produced strong and significant differences in the probability of panic attacks, panic disorder, and panic disorder with agoraphobia. Persons with less than 12 years of education were more than four times as likely to have panic attacks, more than 10 times as likely to have panic disorders, and more than seven times as likely to have panic disorder with agoraphobia versus the reference group with a college education (16 or more years). The pattern is not linear, in that those with some college education have odds similar to the odds of those who finish college, and those who do not complete high school have odds similar to the odds of those who complete high school but take no further education. Therefore, the occurrence of panic might well be related to stressful situations in which the individual is at a disadvantage relative to others. On the other hand, panic might be strongly mediated by cognitive factors involving the appraisal of risk. Working people, married people, and those living with others have a generally lower estimated prevalence of panic. Those living in a city appear to have a somewhat greater prevalence of panic, but the result is not statistically significant. The estimated prevalence of panic and related experiences is very different in men and women. The preponderance of women among patients with anxiety disorders is a consistent epidemiological and clinical finding. In every category of increasing severity of panic disorder, the prevalence is slightly more than twice as great among women as among men, as in the ECA results: across epidemiological surveys the ratio of females to males varying from 1.3 to 5.8. Among agoraphobics women largely predominate: over three-quarters of PD patients manifesting extensive avoidance are women. Women are also more likely to develop phobic complications, to present with generalised anxiety and to suffer more depression. Male patients have a significantly longer duration of illness compared with females. Women suffer significantly more frequently from anticipatory anxiety and from current or past depressive mood. In spite of the longer duration of illness in male patients, the less frequent occurrence of concomitant phobic avoidance and depressive disorders in males indicates that men might be less severely impaired than female patients. Males also display less frequent search for help; the economic imperative of males to work may help reduce agoraphobia.
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