Is there evidence for panic disorder in children and adolescents?

In DSM-IV, childhood anxiety disorders are diagnosed according to criteria for adults. However, there is an ongoing controversy whether panic disorder does actually occur in childhood. The current paper critically reviews findings from epidemiological, clinical, and experimental studies addressing this issue. There is a vast amount of evidence that even preadolescent children experience panic attacks that are similar to panic attacks in adulthood. However, the consequences of untriggered panic attacks, such as extensive worry or substantial behavior changes, as demanded for a DSM-IV diagnosis of panic disorder, are extremely rare before adolescence. Panic attacks in childhood are rather unspecific markers of an increased risk for psychopathology than a prodromal symptom for panic disorder in adulthood.