Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community study

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

doi:10.1016/j.jad.2014.08.012

Does help-seeking alter the risk for incident psychopathology in adolescents and young adults with and without fearful spells or panic attacks? Findings from a 10-year prospective-longitudinal community study

J Affect Disord. 2014 Dec:169:221-7. doi: 10.1016/j.jad.2014.08.012. Epub 2014 Aug 15.

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, 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: 25216465
DOI: 10.1016/j.jad.2014.08.012

Abstract

Background: Although fearful spells (FS) and panic attacks (PA) increase the risk for various mental disorders, few studies have examined whether help-seeking in those with FS/PA attenuates the risk for incident psychopathology.

Methods: A community sample of adolescents and young adults (N=2978, aged 14-24 at baseline) was followed up in up to 3 assessment waves over 10 years. FS, PA, psychopathology, and help-seeking were assessed using the DSM-IV/M-CIDI. Logistic regressions with interaction terms (adjusted for sex and age) were used to test interactions between FS/PA and help-seeking at baseline on predicting incident psychopathology at follow-up. Cases with panic disorder (PD) at baseline were excluded from all analyses.

Results: FS/PA at baseline predicted the onset of any disorder, any anxiety disorder, PD, agoraphobia, generalized anxiety disorder, social phobia, and depression at follow-up (Odds Ratios, OR 1.62-5.80). FS/PA and help-seeking at baseline interacted on predicting incident PD (OR=0.09) and depression (OR=0.22) at follow-up in a way that FS/PA only predicted the respective disorders in individuals not seeking help at baseline. In those with FS/PA, a higher number of panic symptoms interacted with help-seeking on predicting incident PD (OR=0.63) in a way that a higher number of panic symptoms only increased the risk for PD in those without help-seeking at baseline.

Limitations: Help-seeking at baseline was not restricted to panic-specific interventions, but included treatment due to other psychological problems as well.

Conclusions: Findings suggest that early help-seeking might modify psychopathology trajectories and prevent incident disorders in high-risk individuals with FS/PA.

Keywords: Anxiety; Depression; Fearful spell; Help-seeking; Panic attack; Prospective-longitudinal.

Publication types

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

MeSH terms

Adolescent
Agoraphobia / psychology
Cognitive Behavioral Therapy
Depression / epidemiology
Depression / prevention & control
Fear
Female
Humans
Incidence
Logistic Models
Longitudinal Studies
Male
Panic Disorder / epidemiology
Panic Disorder / prevention & control*
Panic Disorder / psychology
Patient Participation
Phobic Disorders / epidemiology
Phobic Disorders / prevention & control
Prospective Studies
Psychopathology
Risk Factors
Young Adult