Is the course of panic disorder the same in women and men?

Am J Psychiatry. 1998 May;155(5):596-602. doi: 10.1176/ajp.155.5.596.


Objective: Panic disorder with or without agoraphobia has a chronic relapsing course. Factors associated with poor outcome include early onset of illness and phobic avoidance. Several, but not all, authors have found a worse clinical course for women. Using observational, longitudinal data from the Harvard/Brown Anxiety Disorders Research Program, the authors analyzed remission and symptom recurrence rates in panic patients with respect to sex.

Method: Male and female patients (N = 412) in an episode of panic with or without agoraphobia were assessed by structured interview and prospectively followed for up to 5 years. Data on remission, symptom recurrence, and comorbid psychiatric conditions for each sex were compared.

Results: There were no significant differences between men and women in panic symptoms or level of severity at baseline. Women were more likely to have panic with agoraphobia (85% versus 75%), while men were more likely to have uncomplicated panic (25% versus 15%). The rates of remission for panic with or without agoraphobia at 5 years were equivalent in men and women (39%). Of the subjects who achieved remission, 25% of the women and 15% of the men reexperienced symptoms by 6 months. Recurrence of panic symptoms continued to be higher in women (82%) than men (51%) during the follow-up period and was not influenced by concurrent agoraphobia.

Conclusions: This study extends previous findings by showing that not only are women more likely to have panic with concurrent agoraphobia, but they are more likely than men to suffer a recurrence of panic symptoms after remission of panic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age of Onset
  • Agoraphobia / diagnosis
  • Agoraphobia / epidemiology
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Panic Disorder / diagnosis*
  • Panic Disorder / epidemiology
  • Probability
  • Prospective Studies
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Recurrence
  • Severity of Illness Index
  • Sex Factors
  • Treatment Outcome