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Re-examining the differential familial liability of agoraphobia and panic disorder.

Abstract

BACKGROUND
Controversy surrounds the question of whether agoraphobia (AG) exists as an independent diagnostic entity apart from panic. In favor of this position, AG without panic disorder (PD) in parents was found being unrelated to offsprings' risk for AG or PD, albeit it may enhance the familial transmission of PD (Nocon et al., Depress Anxiety 2008;25:422-434). However, a recent behavioral genetic analysis (Mosing et al., Depress Anxiety 2009;26:1004-1011) found an increased risk for both PD and AG in siblings of those with AG without PD, casting doubt on whether AG exists independently of PD. Convincing evidence for either position notably requires considering also other anxiety disorders to establish the position of AG relative to the panic/anxiety spectrum.
METHODS
Familial transmission of panic attacks (PAs), PD, and AG was examined in a 10-year prospective-longitudinal community study of 3,021 adolescents and young adults including completed direct and indirect information on parental psychopathology. Standardized diagnostic assessments using the Munich-Composite International Diagnostic Interview allowed generating exclusive diagnostic groups independent from diagnostic hierarchy rules.
RESULTS
Parental PD without AG was associated with an increased risk for PA and PD+AG, but not for PD without AG or AG without PD in offspring. Parental AG without PD was unrelated to the offsprings' risk for PA, exclusive PD or AG, or PD+AG. Findings were largely unaffected by adjustment for other offspring or parental anxiety disorders.
CONCLUSIONS
Findings provide further evidence for the independence of AG apart from the PD spectrum.

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  • Publisher Full Text

    • Authors

    Knappe S, Beesdo-Baum K, Nocon A, Wittchen HU

    Institution

    Institute of Clinical Psychology and Psychotherapy, Tech-nische Universitaet, Dresden, Germany. knappe@psychologie.tu-dresden.de

    Source

    Depression and anxiety 29:11 2012 Nov pg 931-8

    MeSH

    Adolescent
    Adult
    Agoraphobia
    Child of Impaired Parents
    Cohort Studies
    Female
    Humans
    Longitudinal Studies
    Male
    Panic Disorder
    Parents
    Prospective Studies
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22786750