Between 8% and 28% of individuals experience panic attacks at some time during their life.[2]Olaya B, Moneta MV, Miret M, et al. Epidemiology of panic attacks, panic disorder and the moderating role of age: results from a population-based study. J Affect Disord. 2018 Dec 1;241:627-33.
http://www.ncbi.nlm.nih.gov/pubmed/30172214?tool=bestpractice.com
[3]de Jonge P, Roest AM, Lim CC, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety. 2016 Dec;33(12):1155-77.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5143159
http://www.ncbi.nlm.nih.gov/pubmed/27775828?tool=bestpractice.com
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]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision, (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022. 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]Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1958997
http://www.ncbi.nlm.nih.gov/pubmed/16585471?tool=bestpractice.com
[8]Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.
http://www.ncbi.nlm.nih.gov/pubmed/16649821?tool=bestpractice.com
Panic disorder with agoraphobia has lower lifetime (1.0%) and 12-month (0.5%) estimates.[7]Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1958997
http://www.ncbi.nlm.nih.gov/pubmed/16585471?tool=bestpractice.com
[8]Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.
http://www.ncbi.nlm.nih.gov/pubmed/16649821?tool=bestpractice.com
Pooled data from 14 European countries support epidemiological findings similar to those in the United States.[9]Goodwin RD, Faravelli C, Rosi S, et al. The epidemiology of panic disorder and agoraphobia in Europe. Eur Neuropsychopharmacol. 2005 Aug;15(4):435-43.
http://www.ncbi.nlm.nih.gov/pubmed/15925492?tool=bestpractice.com
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]Kroenke K, Spitzer RL, Williams JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25.
http://www.ncbi.nlm.nih.gov/pubmed/17339617?tool=bestpractice.com
[11]Roy-Byrne PP, Wagner AW, Schraufnagel TJ. Understanding and treating panic disorder in the primary care setting. J Clin Psychiatry. 2005;66 Suppl 4:16-22.
http://www.ncbi.nlm.nih.gov/pubmed/15842183?tool=bestpractice.com
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]Penninx BW, Pine DS, Holmes EA, et al. Anxiety disorders. Lancet. 2021 Mar 6;397(10277):914-27.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9248771
http://www.ncbi.nlm.nih.gov/pubmed/33581801?tool=bestpractice.com
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]Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1958997
http://www.ncbi.nlm.nih.gov/pubmed/16585471?tool=bestpractice.com
[8]Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.
http://www.ncbi.nlm.nih.gov/pubmed/16649821?tool=bestpractice.com
Panic attacks are most likely to develop during the mid-20s, with men presenting slightly earlier than women.[9]Goodwin RD, Faravelli C, Rosi S, et al. The epidemiology of panic disorder and agoraphobia in Europe. Eur Neuropsychopharmacol. 2005 Aug;15(4):435-43.
http://www.ncbi.nlm.nih.gov/pubmed/15925492?tool=bestpractice.com
[13]Clayton AH, Stewart RS, Fayyad R, et al. Sex differences in clinical presentation and response in panic disorder: pooled data from sertraline treatment studies. Arch Womens Ment Health. 2006 May;9(3):151-7.
http://www.ncbi.nlm.nih.gov/pubmed/16292466?tool=bestpractice.com
Panic symptoms during adolescence are predictive of increased risk for other anxiety and mood disorders in adulthood.[14]Hammerness P, Harpold T, Petty C, et al. Characterizing non-OCD anxiety disorders in psychiatrically referred children and adolescents. J Affect Disord. 2008 Jan;105(1-3):213-9.
http://www.ncbi.nlm.nih.gov/pubmed/17572506?tool=bestpractice.com
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]Kessler RC, Chiu WT, Jin R, et al. The epidemiology of panic attacks, panic disorder, and agoraphobia in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2006 Apr;63(4):415-24.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1958997
http://www.ncbi.nlm.nih.gov/pubmed/16585471?tool=bestpractice.com
[8]Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.
http://www.ncbi.nlm.nih.gov/pubmed/16649821?tool=bestpractice.com
The prevalence of panic attacks and panic disorder tends to decrease with age.[2]Olaya B, Moneta MV, Miret M, et al. Epidemiology of panic attacks, panic disorder and the moderating role of age: results from a population-based study. J Affect Disord. 2018 Dec 1;241:627-33.
http://www.ncbi.nlm.nih.gov/pubmed/30172214?tool=bestpractice.com
Panic disorder is highly comorbid with other anxiety, mood, and substance use disorders, including nicotine dependence.[8]Grant BF, Hasin DS, Stinson FS, et al. The epidemiology of DSM-IV panic disorder and agoraphobia in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2006 Mar;67(3):363-74.
http://www.ncbi.nlm.nih.gov/pubmed/16649821?tool=bestpractice.com
[15]Goodwin RD, Lieb R, Hoefler M, et al. Panic attack as a risk factor for severe psychopathology. Am J Psychiatry. 2004 Dec;161(12):2207-14.
http://www.ncbi.nlm.nih.gov/pubmed/15569891?tool=bestpractice.com
[16]Lamers F, van Oppen P, Comijs HC, et al. Comorbidity patterns of anxiety and depressive disorders in a large cohort study: the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychiatry. 2011 Mar;72(3):341-8.
http://www.ncbi.nlm.nih.gov/pubmed/21294994?tool=bestpractice.com
Cigarette smoking may also increase risk for later onset panic disorder.[17]Cosci F, Knuts IJ, Abrams K, et al. Cigarette smoking and panic: a critical review of the literature. J Clin Psychiatry. 2010 May;71(5):606-15.
http://www.ncbi.nlm.nih.gov/pubmed/19961810?tool=bestpractice.com
Comorbidity with depressive disorders is common (33% to 85%) especially among those with agoraphobia.[10]Kroenke K, Spitzer RL, Williams JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25.
http://www.ncbi.nlm.nih.gov/pubmed/17339617?tool=bestpractice.com
[18]Rodriguez BF, Bruce SE, Pagano ME, et al. Relationships among psychosocial functioning, diagnostic comorbidity, and the recurrence of generalized anxiety disorder, panic disorder, and major depression. J Anxiety Disord. 2005;19(7):752-66.
http://www.ncbi.nlm.nih.gov/pubmed/16076422?tool=bestpractice.com
[19]Roy-Byrne PP, Stein MB, Russo J, et al. Panic disorder in the primary care setting: comorbidity, disability, service utilization, and treatment. J Clin Psychiatry. 1999 Jul;60(7):492-9.
http://www.ncbi.nlm.nih.gov/pubmed/10453807?tool=bestpractice.com
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]Penninx BW, Nolen WA, Lamers F, et al. Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA). J Affect Disord. 2011 Sep;133(1-2):76-85.
https://www.sciencedirect.com/science/article/pii/S0165032711001108?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/21496929?tool=bestpractice.com
[21]Teismann T, Lukaschek K, Hiller TS, et al. Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia. BMC Psychiatry. 2018 Sep 24;18(1):305.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154913
http://www.ncbi.nlm.nih.gov/pubmed/30249220?tool=bestpractice.com