Phenomenology of panic disorder in youth

Diler, Rasim Somer; Birmaher, Boris; Brent, David A.; Axelson, David; Firinciogullari, Sekip; Chiapetta, B S Laurel; Bridge, Jeff

doi:10.1002/da.20018

Cited by 33 publications

(34 citation statements)

References 34 publications

(59 reference statements)

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“…40Y44 Diagnostic Statistical Manual of Mental Disorders, Fourth Edition panic disorder was diagnosed in children 11 years or younger (n = 3) in our sample, a finding which is striking, given the low rates of panic disorder in younger children even in specialized mental health settings. 45,46 Moreau and Weissman 47 suggest that children and adolescents with panic disorder may more commonly present to medical rather than mental health settings. In adult NCCP, comorbid panic disorder is associated with more persistent and severe disability compared with NCCP without this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

Lipsitz¹,

Gur²,

Sonnet³

et al. 2010

Pediatric Emergency Care

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Objective: Chest pain is a common presentation in the pediatric emergency department (PED). In the majority of cases, no clear medical cause is found. Among adults with noncardiac chest pain, psychopathology including panic disorder is common. We assessed the likelihood and type of psychopathology as well as the health status of children and adolescents with unexplained chest pain who presented to the PED.Methods: We performed a semistructured diagnostic interview of children 8 to 17 years old who presented to an urban, tertiary-care PED with a primary complaint of chest pain for which no medical cause was found. We used Diagnostic Statistical Manual of Mental Disorders, Fourth Edition criteria to diagnose psychopathology. We also assessed pain severity, extent of other somatic complaints, quality of life, and functional disability using standard, validated instruments. Results:We enrolled 32 children with a mean age of 12.8 (SD, 2.9) years (range, 8Y17 years); 47% were female. Twenty-six (81%) were diagnosed with a Diagnostic Statistical Manual of Mental Disorders, Fourth Edition anxiety disorder; 9 (28%) had full-criteria panic disorder. Quality of life was compromised in multiple domains, and children reported a range of functional disabilities due to chest pain. Other somatic symptoms, including other pain complaints, were commonly reported in this sample.Conclusion: Unexplained chest pain in the PED is frequently associated with potentially treatable anxiety disorders. Emergency physicians should consider the possibility of anxiety disorders in patients with medically unexplained chest pain.C hest pain is a common complaint in the pediatric emergency department (PED). 1Y3 Annually, it accounts for roughly 400,000 emergency visits in the United States for individuals 18 years or younger. 4 Chest pain presents a significant clinical burden for the pediatric emergency room physician 5 and is one of the more common reasons for performing electrocardiograms in the PED. 6 It is also a frequent cause for seeking pediatric cardiologist consultation within the hospital setting 7 and is among the most common reasons for referral to the pediatric cardiologist. 8 Prior to adulthood, chest pain is only rarely an indication of cardiac disease. In studies of children with chest pain, prevalence of cardiac abnormalities ranges from 0% to 10%. 2,3,9Y11 Noncardiac medical diagnoses are common, including musculoskeletal conditions such as costochondritis, 12 pulmonary conditions such as asthma or pneumonia, 13,14 gastrointestinal illnesses, 15,16 or other identifiable causes such as cocaine use. 17 However, most cases have no clear medical explanation. 18 Despite the overall benign medical picture, pediatric chest pain often persists for years after the first visit to the PED or specialist. 19,20 Some children with chest pain make repeated visits for additional medical testing. 21 Many experience disability, including school absence and sleep abnormalities. 2,19,22 Our objective was to conduct a pilot study to determine the li...

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Section: Discussionmentioning

confidence: 99%

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

Lipsitz¹,

Gur²,

Sonnet³

et al. 2010

Pediatric Emergency Care

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“…Kessler et al, 2012, Merikangas et al, 2010), 2-6% in outpatient psychiatric clinic samples of adolescents (e.g. Biederman et al, 1997; Diler et al, 2004), and as high as 15% in inpatient adolescent samples (Alessi, Robbins, & Dilsaver, 1987). Adolescents with PDA suffer from debilitating physical symptoms during panic attacks, including heart palpitations, chest pains, nausea, and shaking/trembling, the repeated occurrence of which contributes to significant distress and functional impairment (Diler et al, 2004; Masi, Favilla, Mucci, & Millepiedi, 2000; Merikangas et al, 2010).…”

mentioning

confidence: 99%

A psychometric evaluation of the Panic Disorder Severity Scale for children and adolescents.

Elkins¹,

Pincus²,

Comer³

2014

Psychological Assessment

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The Panic Disorder Severity Scale (PDSS; Shear et al., 1997) is a well-validated measure that assesses symptoms of panic disorder and agoraphobia (PDA) in adults. The Panic Disorder Severity Scale for Children (PDSS-C) is an adaptation of the PDSS for youth ages 11 to 17. The current study evaluated the psychometric properties of the PDSS-C. Participants included sixty adolescents from an RCT investigating the efficacy of an intensive cognitive behavioral treatment for adolescent PDA. Convergent and discriminant validity of PDSS-C scores were evaluated via observed associations between the PDSS-C and the Childhood Anxiety Sensitivity Index (CASI; Silverman et al., 1991), Multidimensional Anxiety Scale for Children (MASC; March et al., 1997), and Children’s Depression Inventory (CDI; Kovacs, 2003). Baseline and post-treatment data afforded the opportunity to evaluate the measure’s sensitivity to treatment-related change. PDSS-C scores demonstrated acceptable internal consistency (α = 0.82) and adequate 1-day test-retest reliability (r = 0.79). Convergent and discriminant validity of the PDSS-C scores were supported through significant associations with the CASI and the MASC, and non-significant associations with the CDI, respectively. Linear regression analysis demonstrated sensitivity to treatment-related changes—i.e., greater PDSS-C change scores were significantly associated with assignment to CBT versus waitlist condition. Clinical utility was further established through significant associations between PDSS-C change scores and MASC and CASI change scores, and through non-significant associations with CDI change scores. Results support the use of PDSS-C scores as reliable, valid, and clinically useful for the assessment of youth panic disorder in research and clinical settings.

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“…Contrary to this finding, other studies argue that there are no differences in the symptoms presented by children and adults or children and adolescents 19,21 …”

Section: What Are the Clinical Manifestations Of Pd In Adults?mentioning

confidence: 71%

“…Symptoms of PD in children and adolescents are similar to those experienced by adults, such as palpitations, tremors, restlessness, dizziness, shortness of breath, weakness, sweating, chest pain, abdominal discomfort, nausea, numbness, and fear of losing control [19][20][21] (B). Although PD is considered rare in young individuals, the frequency of the disorder may range from 0.5 22 (B) to 2% 21 (B); rates as high as 6% have been reported.…”

Section: What Are the Clinical Manifestations Of Pd In Adults?mentioning

confidence: 99%

“…Although PD is considered rare in young individuals, the frequency of the disorder may range from 0.5 22 (B) to 2% 21 (B); rates as high as 6% have been reported. No epidemiological data are available for agoraphobia, except from patients referred to pediatric clinical services, with rates between 15 23 (B) and 18% 22 (B).…”

Section: What Are the Clinical Manifestations Of Pd In Adults?mentioning

confidence: 99%

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Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

Levitan

Chagas

Linares

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed), Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for ''patient'' [or population], ''intervention'' [or exposure], ''comparison'' [or control], and ''outcome''). Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

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Phenomenology of panic disorder in youth

Cited by 33 publications

References 34 publications

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

A psychometric evaluation of the Panic Disorder Severity Scale for children and adolescents.

Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

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