All authors declare to have no conflict of interest regarding this work.
RE-EXAMINING THE DIFFERENTIAL FAMILIAL LIABILITY OF AGORAPHOBIA AND PANIC DISORDER
Article first published online: 11 JUL 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 11, pages 931–938, November 2012
How to Cite
Knappe, S., Beesdo-Baum, K., Nocon, A. and Wittchen, H.-U. (2012), RE-EXAMINING THE DIFFERENTIAL FAMILIAL LIABILITY OF AGORAPHOBIA AND PANIC DISORDER. Depress. Anxiety, 29: 931–938. doi: 10.1002/da.21975
- Issue published online: 5 NOV 2012
- Article first published online: 11 JUL 2012
- Manuscript Accepted: 26 MAY 2012
- Manuscript Revised: 8 MAY 2012
- Manuscript Received: 22 DEC 2011
- panic disorder;
- familial aggregation;
- cohort study, liability
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.
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.
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.
Findings provide further evidence for the independence of AG apart from the PD spectrum.