Epidemiology

Between 8% and 28% of individuals experience panic attacks at some time during their life.[2][3] The prevalence estimates for panic disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revisions (DSM-5-TR) are approximately 2% to 3% for adolescents and adults. The global lifetime prevalence is estimated at 1.7%.[1] In the DSM-5-TR, agoraphobia is now an independently diagnosed condition, and hence comorbidity data with panic disorder are pending. According to DSM-IV-TR diagnostic criteria in which panic disorder could be specified with or without agoraphobia, the lifetime and the 12-month prevalence of panic disorder without agoraphobia are approximately 4.0% and 1.5%, respectively.[7][8] Panic disorder with agoraphobia has lower lifetime (1.0%) and 12-month (0.5%) estimates.[7][8] Pooled data from 14 European countries support epidemiological findings similar to those in the United States.[9] The rate of panic disorder in primary care is approximately 7.0%, and is substantially higher among patients presenting with cardiac and gastrointestinal symptoms.[10][11]

Anxiety disorders in general are most prevalent in higher-income countries, although it is unclear whether this finding reflects a true difference in prevalence, or differences in diagnostic criteria and reporting.[12] The odds of developing panic attacks and panic disorder are higher among Native Americans compared with white people, and lower among Asian, Hispanic, and black people.[7][8]

Panic attacks are most likely to develop during the mid-20s, with men presenting slightly earlier than women.[9][13] Panic symptoms during adolescence are predictive of increased risk for other anxiety and mood disorders in adulthood.[14] Panic disorder with and without agoraphobia is most likely to develop between the early 20s and early 30s, the disorder being 2 to 3 times more common among women than men.[7][8] The prevalence of panic attacks and panic disorder tends to decrease with age.[2]

Panic disorder is highly comorbid with other anxiety, mood, and substance use disorders, including nicotine dependence.[8][15][16] Cigarette smoking may also increase risk for later onset panic disorder.[17] Comorbidity with depressive disorders is common (33% to 85%) especially among those with agoraphobia.[10][18][19] Comorbidity with depression may signify a more severe and longer-term course of illness, with panic attacks being independently associated with an increased risk of suicidal thoughts and suicide attempts.[20][21]

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