Panic disorder in children and adolescents

In the light of the current interest in the development of this disorder in adults, a number of recent studies have been devoted to the condition in children and adolescents. These papers include retrospective studies of adults suffering from the disorder, clinical reports on children or adolescents with the same problems, epidemiological studies of children and adolescents consulting psychiatrists, epidemiological studies of the general population, family studies, and studies of chemotherapeutic treatments. The conclusion from these papers is that many children and adolescents who present with physical symptoms are suffering from a panic disorder which has not been identified as such at the lime. Other studies have analysed the age of onset of the first attack. All these studies are now in agreement in confirming that adolescence is the preferential age of onset of panic disorder. There even appears to be a correlation between the stages of puberty (Tanner) and the onset of panic attacks in young adolescents. At each successive stage of puberty, C. Hayward et al. (1992) found a progressively higher rate of panic attacks. ''Panic disorder'' thus preferentially develops in adolescence, more commonly in girls than boys, particularly in subjects who are prone to anxiety or show traits of the ''avoiding personality'', but who also have a depressive tendency. A number of studies also suggest that pathological separation anxiety developing in childhood represents a risk factor for the development of ''panic disorder'' and/or agoraphobia during adolescence or adult life. The natural history of Panic Disorder in adolescence is still little known. The greatest risk appears to be chronic anxiety, but the progressive establishment of panic disorder, its development in the direction of depressive disorder, and self-medication and/or abuse of psychotropic drugs, also give cause for concern. Finally, a number of psychopathological considerations have raised the possibility that the onset of a panic disorder may be a danger signal of an underlying depressive personality.