Abstract
The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective measures. Approximately half of the youngsters with panic disorder also met criteria for the diagnosis of agoraphobia. There was extensive comorbidity between panic disorder and other internalizing and externalizing disorders. Parents reported clinically significant levels of child symptomatology on the CBCL. Teacher-and child-reported symptomatology on the CBCL was within the normal range. At the same time, it was notable that no child had been referred specifically for evaluation or treatment of panic disorder or agoraphobia. Implications for clinical assessment/identification and treatment are discussed.
Similar content being viewed by others
References
Kearney CA, Silverman K (1992) Let“s not push the ”panic button““: a critical analysis of panic and panic disorder in adolescents. Clin Psychol Rev 12:293–305
Nelles WB, Barlow DH (1988) Do children panic?. Clin Psychol Rev 8:359–372
Birmaher B, Ollendick TH (2004) Childhood-onset panic disorder. In: Ollendick TH, March JS (eds). Phobic and anxiety disorders in children and adolescents. Oxford University Press, New York, pp 306–333
Moreau D, Weissman MM (1992) Panic disorder in children and adolescents: a review. Am J Psychiat 149:1306–1314
Ollendick TH (1998) Panic disorder in children and adolescents: new developments, new directions. J Clin Child Psychol 27:234–245
Ollendick TH, Mattis SG, King NJ (1994) Panic in children and adolescents: a review. J Child Psychol Psychiat 35:113–134
Essau CA, Conradt J, Petermann F (1999) Frequency of panic attacks and panic disorder in adolescents. Depress Anxiety 9:19–26
Lewinsohn PM, Hops H, Roberts RE, Seeley JR, Andrews JA (1993) Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol 102:133–144
Warren R, Zgourides G (1988) Panic attacks in high school students: implications for prevention and intervention. Phobia Prac Res J 1:97–113
Whitaker A, Johnson J, Shaffer D, Rapoport JL et al (1990) Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population. Arch Gen Psychiat 47:487–496
Alessi NE, Robbins DR, Dilsaver SC (1987) Panic and depressive disorders among psychiatrically hospitalized adolescents. Psychiat Rep 20:275–283
Biederman J, Faraone SV, Marrs A, Moore P, Garcia J, Ablon S, Mick E, Gershon J, Kearns ME (1997) Panic disorder and agoraphobia in consecutively referred children and adolescents. J Am Acad Child Adolesc Psychiat 36:214–223
Last CG, Strauss CC (1989) Panic disorder in children and adolescents. J Anxiety Dis 3:87–95
Masi G, Favilla L, Mucci M, Millepiedi S (2000) Panic disorder in clinically referred children and adolescents. Child Psychiat Hum Devel 31:139–151
Klein DF, Mannuzza S, Chapman T, Fyer A (1992) Child panic revisited. J Am Acad Child Adolesc Psychiat 31:112–113
Clark DM (1996) A cognitive approach to panic. Behav Res Ther 24:461–470
Kearney CA, Albano AM, Eisen AR, Allan WD, Barlow DH (1997) The phenomenology of panic disorder in youngsters: an empirical study of a clinical sample. J Anxiety Dis 11:49–62
Vitiello BV, Behar D, Wolfson S, McLeer SV (1990) Diagnosis of panic disorder in prepubertal children. J Am Acad Child Adolesc Psychiat 25:782–784
Weissman MM, Klerman GL, Markowitz JS, Quellette R (1989) Suicide ideation and suicide attempts in panic disorder and panic attacks. N Eng J Med 321:1209–1214
Ollendick TH (1995) Cognitive-behavioral treatment of panic disorder with agoraphobia in adolescents: a multiple baseline design analysis. Behav Ther 26:517–531
Bradley SJ, Hood J (1993) Psychiatrically referred adolescents with panic attacks: presenting symptoms, stressors, and comorbidity. J Am Acad Child Adolesc Psychiat 32:826–829
Barlow DH (2002) Anxiety and its disorders, 2nd edn. Guilford Press, New York
Southam-Gerow MA, Weisz JR, Kendall PC (2003) Youth with anxiety disorders in research and service clinics: examining client differences and similarities. J Clin Child Adolesc Psychol 32:375–385
Grills AE, Ollendick TH (2002) Issues in parent-child agreement: the case of structured diagnostic interviews. Clin Child Family Rev 5:57–83
Russo MF, Beidel DC (1994) Comorbidity of childhood anxiety, externalizing disorders: prevalence, associated characteristics, and validation issues. Clin Psychol Rev 14:199–221
Orvaschel H (1995) Schedule for affective disorders and schizophrenia for school-aged children. Epidiologic Version – 5. Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL
Costello AJ (1986) Assessment and diagnosis of affective disorders. J Child Psychol Psychiat 27:565–574
Schniering CA, Hudson JL, Rapee RM (2000) Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clin Psychol Rev 20:453–478
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. text rev Author, Washington, DC
Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Measure 20:37–46
Green B, Shirk S, Hanze D, Wanstrath J (1994) The children“s global assessment scale in clinical practice: an empirical evaluation. J Am Acad Child Adolesc Psychiat 33:1158–1164
Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A children“s global assessment scale (CGAS). Arch General Psychiat 40:1228–1231 123
Bartko JJ (1966) The intraclass correlation coefficient as a measure of reliability. Psychol Rep 19:3–11
Guy W (1976) Assessment manual for psychopharmacology. U.S. Department of Health, Education, and Welfare, Washington, DC
Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. University of Vermont, Department of Psychiatry, Burlington, VT
Achenbach TM (1991) Manual for the teachers report form and 1991 profile. University of Vermont, Department of Psychiatry, Burlington, VT
Achenbach TM (1991) Manual for the youth self-report and 1991 profile. University of Vermont, Department of Psychiatry, Burlington, VT
Mattis SG, Ollendick TH (1997) Panic in children and adolescents: a developmental analysis. In: Ollendick TH, Prinz RJ (eds). Advances in clinical child psychology, vol 19. Plenum, New York, pp 27–94
Shear MK (1996) Factors in the etiology and pathogenesis of panic disorder: revisiting the attachment-separation paradigm. Am J Psychiat 153(Suppl 7):125–136
Gittelman R, Klein DF (1985) Childhood separation anxiety and adult agoraphobia.. In: Tuma AH, Maser J (eds). Anxiety and the anxiety disorders. Lawrence Erlbaum, Hillsdale, NJ, pp 389–402
Alessi NE, Magen J (1988) Panic disorders in psychiatrically hospitalized children. Am J Psychiat 145:1450–1452
Essau CA, Conradt J, Petermann F (2000) Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents. J Anxiety Dis 14:263–279
Goodwin RD, Lieb R, Hoefler M, Pfister H, Bittner A, Beesdo K, Wittchen HU (2004) Panic attack as a risk factor for severe psychopathology. Am J Psychiat 161:2207–2214
Birmaher B, Kennah A, Brent D, Ehmann M, Bridge J, Axelson D (2002) Is bipolar disorder specifically associated with panic disorder in youths? J Clin Psychiat 63:414–419
Masi G, Toni C, Perugi G, Mucci M, Millepiedi S, Akiskal HS (2001) Anxiety disorders in children and adolescents with bipolar disorder: a neglected comorbidity. Can J Psychiat 46:797–802
Biederman J, Faraone SV, Keenan K, Knee D, Tsuang MT (1990) Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. J Am Acad Child Adolesc Psychiat 29:526–533
Biederman J, Faraone SV, Keenan K, Steingard R et al (1991) Familial association between attention deficit disorder and anxiety disorders. Am J Psychiat 148:251–256
Last CG, Strauss CC, Francis G (1987) Comorbidity among childhood anxiety disorders. J Nervous Mental Dis 175:726–730
Kovacs M, Paulauskas S, Gatsonis C, Richards C (1988) Depressive disorders in childhood III: a longitudinal study of comorbidity with and risk for conduct disorders. J Affect Dis 15:205–217
Kendall PC, Flannery-Schroeder EC, Panichelli-Mindel SP, Southam-Gerow MA, Henin A, Warmann MJ (1997) Treating anxiety disorders in youth: a second randomized clinical trial. J Consult Clin Psychol 65:366–380
Author information
Authors and Affiliations
Corresponding author
Additional information
This paper was presented at the 39th Annual Convention of the Association for Behavioral and Cognitive Therapies, November 18, 2005, Washington, DC.
Rights and permissions
About this article
Cite this article
Doerfler, L.A., Connor, D.F., Volungis, A.M. et al. Panic Disorder in Clinically Referred Children and Adolescents. Child Psychiatry Hum Dev 38, 57–71 (2007). https://doi.org/10.1007/s10578-006-0042-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10578-006-0042-5