Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: a 10-year prospective-longitudinal community study of adolescents and young adults

Eva Asselmann; Hans-Ulrich Wittchen; Roselind Lieb; Michael Höfler; Katja Beesdo-Baum

doi:10.1016/j.jpsychires.2014.04.001

Associations of fearful spells and panic attacks with incident anxiety, depressive, and substance use disorders: a 10-year prospective-longitudinal community study of adolescents and young adults

J Psychiatr Res. 2014 Aug:55:8-14. doi: 10.1016/j.jpsychires.2014.04.001. Epub 2014 Apr 12.

Authors

Eva Asselmann¹, Hans-Ulrich Wittchen², Roselind Lieb³, Michael Höfler⁴, Katja Beesdo-Baum⁵

Affiliations

¹ Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany. Electronic address: Eva.Asselmann@tu-dresden.de.
² Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Max Planck Institute of Psychiatry, Munich, Germany.
³ Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland.
⁴ Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany.
⁵ Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Germany.

PMID: 24774646
DOI: 10.1016/j.jpsychires.2014.04.001

Abstract

Objective: The concept of fearful spells (FS) denotes distressing spells of anxiety that might or might not qualify for criteria of panic attacks (PA). Few studies examined prospective-longitudinal associations of FS not meeting criteria for PA with the subsequent onset of mental disorders to clarify the role of FS as risk markers of psychopathology.

Method: A representative community sample of adolescents and young adults (N = 3021, age 14-24 at baseline) was prospectively followed up in up to 3 assessment waves over up to 10 years. FS, PA, anxiety, depressive, and substance use disorders were assessed using the DSM-IV/M-CIDI. Odds Ratios (OR) from logistic regressions were used to examine the predictive value of FS-only (no PA) and PA at baseline for incident disorders at follow-up.

Results: In logistic regressions adjusted for sex and age, FS-only predicted the onset of any subsequent disorder, any anxiety disorder, panic disorder, agoraphobia, GAD, social phobia, any depressive disorder, major depression, and dysthymia (ORs 1.54-4.36); PA predicted the onset of any anxiety disorder, panic disorder, GAD, social phobia, any depressive disorder, major depression, dysthymia, any substance use disorder, alcohol abuse/dependence, and nicotine dependence (ORs 2.08-8.75; reference group: No FS-only and no PA). Associations with psychopathology were slightly smaller for FS-only than for PA, however, differences in associations (PA compared to FS-only) only reached significance for any anxiety disorder (OR = 3.26) and alcohol abuse/dependence (OR = 2.26).

Conclusions: Findings suggest that compared to PA, FS-only have similar predictive properties regarding subsequent psychopathology and might be useful for an early identification of high-risk individuals.

Keywords: Anxiety; Depression; Fearful spell; Panic attack; Prospective-longitudinal; Substance use.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Age Factors
Anxiety Disorders / epidemiology*
Depressive Disorder / epidemiology*
Diagnostic and Statistical Manual of Mental Disorders
Fear*
Female
Follow-Up Studies
Humans
Logistic Models
Longitudinal Studies
Male
Odds Ratio
Panic Disorder / epidemiology*
Prospective Studies
Psychiatric Status Rating Scales
Severity of Illness Index
Sex Factors
Substance-Related Disorders / epidemiology*
Young Adult