A Comparison of Persons With Early- Versus Late-Onset Panic Attacks

Background: Although some evidence suggests abimodal age at onset of panic attacks, the literature comparingsubjects with early versus late onset is limited. Previous worksuggests that people with late-onset panic attacks may have fewerpanic symptoms and exhibit less avoidance. This study sought tocompare late-onset panic attacks and early-onset panic attackswith regard to (1) comorbidity, (2) health care utilization, and(3) illness behaviors and coping.

Method: This community-based study involvedinterviewing randomly selected adults for the presence ofDSM-III-R panic attacks. If panic attacks were confirmed,subjects were asked questions concerning panic characteristics,psychiatric comorbidity, symptom perceptions, illness attitudes,coping, and family characteristics. Subjects reportingearly-onset panic (panic onset = 50 years ofage). Significant univariate analyses were controlled fordifferences in age, panic duration, and socioeconomic status byusing analysis of covariance and logistic regression.

Results: Subjects with late-onset panic attacks(N = 9) utilized the mental health sector less, but were morelikely to present to family physicians for their worst panic.Patients with late-onset panic felt that choking and numbnessmore strongly disrupted function, but felt less strongly thateither depersonalization or sweating disrupted function. Subjectswith late-onset had fewer comorbid conditions and lower SymptomChecklist-90 scores. Late-onset subjects also had lesshypochondriasis and thanatophobia while coping less throughavoidance or wishful thinking.

Conclusion: Late-onset panic attacks areassociated with less mental health utilization, lower levels ofcomorbidity, less hypochondriasis, and a greater number ofpositive coping behaviors.