Adolescent panic attacks are associated with increased risk of personality disorder as a young adult

摘要

This paper builds upon a body of research showing that a panic attack may mark risk for a range of mental disorders' rather than only indicating panic disorder or acute transient distress.2 Presentations to health services with panic attacks may provide more than the opportunity to prevent panic disorder.3 They may be a useful cue for the recognition and management of a much wider variety of mental disorders.In the present study panic attacks in adolescence were significantly related to personality disorders 10 years later. Of the 59 who experienced panic attacks as adolescents 17 (28.8%) met criteria for a personality disorder 10 years later compared with 72 (12.5%) of the 575 who did not report panic attacks. The positive predictive value of a panic attack for future personality disorders is 0.288, while tne negative predictive value is 0.875. Thus the absence of panic attacks is more indicative of the absence of personality disorder than the presence indicates personality disorders.One caveat on the present study is that a panic attack was defined as one or more of the typical list of symptoms while DSM-IV requires at least four. So panic attacks in this study may better fit with what has otherwise been described as fearful spells.Some questions remain for future research. How do panic attacks compare with other risk factors for personality and other mental disorders? Are the benefits of early recognition sufficiently large to convince those working outside mental health services that it is useful to pay more attention to panic attacks? What mechanisms might account for the relationship?At the very least this paper reminds us that diagnoses other than panic disorder should be more actively considered when people present with panic attacks.