The Age of Onset of Anxiety Disorders

Background The co-occurrence of anxiety disorders with other mental, addictive, and physical disorders has important implications for treatment and for prediction of clinical course and associated morbidity.Method Cross-sectional and prospective data on 20 291 individuals from the Epidemiologic Catchment Area (ECA) study were analysed to determine one-month, current disorders, one-year incidence, and one-year and lifetime prevalence of anxiety, mood, and addictive disorders, and to identify the onset and offset of disorders within the one-year prospective period.Results Nearly half (47.2%) of those meeting lifetime criteria for major depression also have met criteria for a comorbid anxiety disorder. The average age of onset of any lifetime anxiety disorder (16.4 years) and social phobia (11.6 years) among those with major depression was much younger than the onset age for major depression (23.2 years) and panic disorder.Conclusions Anxiety disorders, especially social and simple phobias, appear to have an early onset in adolescence with potentially severe consequences, predisposing those affected to greater vulnerability to major depression and addictive disorders.

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Anxiety Disorders: Similarities and Differences of Comorbidity in Treated and Untreated Groups

The British Journal of Psychiatry ◽

10.1192/s0007125000296219 ◽

1991 ◽

Vol 159 (S12) ◽

pp. 23-33 ◽

Cited By ~ 61

Author(s):

Hans-Ulrich Wittchen ◽

Cecilia Ahmoi Essau ◽

Jürgen-Christian Krieg

Keyword(s):

Anxiety Disorders ◽

Depressive Disorders ◽

Age Of Onset ◽

Clinical Sample ◽

Clinical Samples ◽

Max Planck ◽

Two Samples ◽

Similarities And Differences ◽

Depressive Episodes

The similarities and differences of comorbidity in treated and untreated samples with anxiety disorders were examined using data from the Munich Follow-up Study: 133 subjects with anxiety and depressive disorders and 101 former in-patients at the Max Planck Institute for Psychiatry. Diagnoses were based on the DIS, not using the optional DSM—III exclusion rules. In these epidemiological and clinical samples, 69% and 95% respectively had at least two diagnoses. The epidemiological sample was clearly differentiated from the clinical sample by age of onset. The development of both depressive episodes and substance disorders in the two samples was mostly secondary to the development of anxiety problems. The outcome for subjects with both anxiety and depressive disorders tended to be worse than that for those with anxiety alone, regardless of whether a depressive episode was present at the time of the follow-up investigation. The usefulness is underlined of the comorbidity concept based on operationalised diagnosis without the exclusion rules offered by DSM—III and DSM—III—R.

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Age of onset and temporal sequencing of lifetime DSM-IV alcohol use disorders relative to comorbid mood and anxiety disorders

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2007.11.022 ◽

2008 ◽

Vol 94 (1-3) ◽

pp. 234-245 ◽

Cited By ~ 88

Author(s):

Daniel E. Falk ◽

Hsiao-ye Yi ◽

Michael E. Hilton

Keyword(s):

Alcohol Use ◽

Anxiety Disorders ◽

Age Of Onset ◽

Alcohol Use Disorders ◽

Mood And Anxiety Disorders ◽

Temporal Sequencing ◽

Dsm Iv

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Reducing Fear During Childhood to Prevent Anxiety Disorders Later: Insights From Developmental Psychobiology

Policy Insights from the Behavioral and Brain Sciences ◽

10.1177/2372732217719544 ◽

2017 ◽

Vol 4 (2) ◽

pp. 131-138 ◽

Cited By ~ 4

Author(s):

Jee Hyun Kim

Keyword(s):

Anxiety Disorders ◽

School Psychologists ◽

Health Service Utilization ◽

Developmental Disorders ◽

Age Of Onset ◽

Behavioral Therapy ◽

Developmental Psychobiology ◽

Fear And Anxiety ◽

Older Populations ◽

Therapy Sessions

Anxiety disorders are neurodevelopmental with the median age of onset 10 to 11 years, but developmental processes underlying fear and anxiety are rarely investigated. In the last decade, however, developmental rodent studies have increased our understanding of how to treat and prevent the persistence of anxiety. Behavioral findings from rodent studies match the observations in anxious children, and the neural and molecular findings help explain why anxiety disorders are indeed neurodevelopmental. Extinction processes that are involved in cognitive-behavioral therapy appear particularly effective in children compared with older populations. Policy should mandate school psychologists and government subsidies for therapy sessions to increase children’s mental-health-service utilization. Funding bodies also should challenge anxiety studies exclusively targeting adults to include younger people to investigate why anxiety disorders are developmental disorders and focus more on preventing their persistence later in life.

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Anxiety disorders in anorexia nervosa and bulimia nervosa: co-morbidity and chronology of appearance

European Psychiatry ◽

10.1016/s0924-9338(00)00212-1 ◽

2000 ◽

Vol 15 (1) ◽

pp. 38-45 ◽

Cited By ~ 224

Author(s):

N.T. Godart ◽

M.F. Flament ◽

Y. Lecrubier ◽

P. Jeammet

Keyword(s):

Anorexia Nervosa ◽

Anxiety Disorder ◽

Bulimia Nervosa ◽

Anxiety Disorders ◽

Separation Anxiety ◽

Age Of Onset ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Separation Anxiety Disorder ◽

Co Morbidity

SummaryThe objectives of the study were to assess lifetime prevalence of specific anxiety disorders, and their age of onset relative to that of eating disorders (ED), in a French sample of patients with anorexia nervosa (AN) or bulimia nervosa (BN). We assessed frequencies of seven anxiety disorders and childhood histories of separation anxiety disorder among 63 subjects with a current DSM-IV diagnosis of an ED, using the Composite International Diagnostic Interview (CIDI). Eighty-three percent of subjects with AN and 71% of those with BN had at least one lifetime diagnosis of an anxiety disorder. By far, the most frequent was social phobia (55% of the anorexics and 59% of the bulimics). When present, the co-morbid anxiety disorder had predated the onset of the ED in 75% of subjects with AN, and 88% of subjects with BN. Our results are consistent with those of studies conducted in other countries, and show that an anxiety disorder frequently exists before an ED. This has to be taken in consideration for successful treatment of patients with AN or BN.

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Age of onset, clinical characteristics, and 15-year course of anxiety disorders in a prospective, longitudinal, observational study

Journal of Affective Disorders ◽

10.1016/j.jad.2011.01.006 ◽

2011 ◽

Vol 132 (1-2) ◽

pp. 260-264 ◽

Cited By ~ 53

Author(s):

Holly J. Ramsawh ◽

Risa B. Weisberg ◽

Ingrid Dyck ◽

Robert Stout ◽

Martin B. Keller

Keyword(s):

Observational Study ◽

Anxiety Disorders ◽

Clinical Characteristics ◽

Age Of Onset ◽

Longitudinal Observational Study ◽

Prospective Longitudinal

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Obsessive-Compulsive Disorder

Anxiety Disorders in Adults ◽

10.1093/oso/9780195369250.003.0010 ◽

2009 ◽

Author(s):

Vladan Starcevic, MD, PhD

Keyword(s):

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Age Of Onset ◽

Clinical Manifestations ◽

Severity Of Illness ◽

Repetitive Behaviors ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Close Relationship

As its name implies, the main characteristics of obsessive-compulsive disorder (OCD) are obsessions and/or compulsions. Different types of obsessions and compulsions make OCD a heterogeneous condition. Also, OCD exists on a continuum from mild cases to those with extremely severe and incapacitating manifestations generally not seen in other anxiety disorders. Clinical manifestations of OCD are striking and leave few people who observe them unimpressed. This is arguably due to the seriousness with which persons with OCD take their own obsessions and compulsions along with concurrent realization that these same obsessions and compulsions are senseless and should be gotten rid of. Indeed, there are few other examples in psychopathology where insight and deficiency of insight stand together, and where espousing and fighting the absurd are so intertwined. For all these reasons, OCD is often portrayed as a puzzling or intriguing disorder; in addition, it often represents a treatment challenge. Obsessive-compulsive disorder is probably the least controversial condition within the anxiety disorders because its clinical features are well described and relatively easily recognized and because hardly anyone doubts its existence as a psychopathological entity. What is controversial about OCD, however, is where it belongs and how it should be classified. This is a consequence of a number of features of OCD that make it look different from other anxiety disorders and of the close relationship that OCD has with some conditions outside of the realm of anxiety disorders. Listed below are a number of key questions about OCD…. 1. In view of its different clinical features and the vastly different severity of these features, should OCD be considered a unitary condition or divided into subtypes? 2. If OCD is to be divided into subtypes, on the basis of what criteria should it be done? Types of obsessions and compulsions, reasons for performing compulsions, severity of illness, degree of insight, age of onset, or something else? 3. Should neutralizing responses other than compulsions be given a more prominent role in the description and conceptualization of OCD? 4. How does insight contribute to the conceptualization of OCD? 5. What are the core features of OCD? Is OCD primarily an affective disorder, is it characterized by a primary disturbance in thinking, or is it essentially a disorder of repetitive behaviors?

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The age of onset of anxiety disorders in samples from the general population: A meta-analysis

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.936 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S56-S57 ◽

Cited By ~ 1

Author(s):

J. de Lijster ◽

B. Dierckx ◽

E. Utens ◽

F. Verhulst ◽

C. Zieldorff ◽

...

Keyword(s):

Gender Differences ◽

Anxiety Disorder ◽

General Population ◽

Anxiety Disorders ◽

Study Design ◽

Age Of Onset ◽

Meta Analysis ◽

Separation Anxiety Disorder ◽

Inclusion Criteria ◽

Study Characteristics

WorkshopAge of onset of mental disorders: etiopathogenetic and treatment implications.BackgroundAge of onset (AOO) of anxiety disorders could serve as a vital statistic in the formulation of mental health policy. Previous reviews have reported on the AOO of anxiety disorders in the general population. However, these review studies did not systematically estimate the AOO of different anxiety disorder subtypes, and did not examine factors that might have influenced reported AOO.ObjectiveThe aims of the present study were (1) to estimate the AOO for all anxiety disorders and for specific subtypes, (2) to examine gender differences in AOO of anxiety disorders, and (3) to examine the influence of study characteristics on reported AOO.MethodSeven electronic databases were searched with keywords representing anxiety disorder subtypes, AOO and study design. The inclusion criteria were studies using a general population sample that provided data on AOO for all anxiety disorders, or specific anxiety disorders, according to DSM-III-R, DSM-IV or ICD-10 criteria. Meta-analysis was used to estimate AOO and gender differences, while meta-regression was used to examine the influence of study characteristics.ResultsA total of 1028 titles were examined, which yielded 24 studies meeting the inclusion criteria. Meta-analysis found an average AOO of all anxiety disorders of 21.3 years (95% CI: 17.46 to 25.07). Separation anxiety disorder, specific phobia and social phobia had their mean onset before the age of 15 years, whereas AOO of agoraphobia, obsessive compulsive disorder, post-traumatic stress disorder, panic disorder and generalized anxiety disorder began on average between 21.1 and 34.9 years. Anxiety disorder is more common in women, but meta-analysis revealed no difference in AOO between genders. Prospective study design and higher developmental level of the study country were associated with earlier AOO.ConclusionResults from this meta-analysis indicate that anxiety disorder subtypes differ in mean AOO, with onsets ranging from early adolescence to young adulthood. These findings suggest that prevention strategies of anxiety disorders should be directed towards the factors associated with the development of subtypes of anxiety disorder in the age groups with the greatest vulnerability for developing those disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The role of fear and anxiety in the familial risk for major depression: a three-generation study

Psychological Medicine ◽

10.1017/s0033291708002894 ◽

2008 ◽

Vol 38 (11) ◽

pp. 1543-1556 ◽

Cited By ~ 15

Author(s):

V. Warner ◽

P. Wickramaratne ◽

M. M. Weissman

Keyword(s):

Anxiety Disorders ◽

First Generation ◽

Age Of Onset ◽

Familial Risk ◽

Mediating Effect ◽

Cox Proportional Hazard ◽

Increased Risk ◽

Cox Proportional Hazard Models ◽

Fear And Anxiety ◽

Risk For Depression

BackgroundThe overlap between anxiety and major depressive disorder (MDD), the increased risk for depression and anxiety in offspring of depressed parents, the sequence of onset with anxiety preceding MDD, and anxiety as a predictor of depression are well established. The specificity of anxiety disorders in these relationships is unclear. This study, using a longitudinal high-risk design, examined whether anxiety disorders associated with the emotions fear and anxiety mediate the association between parental and offspring depression.MethodTwo hundred and twenty-four second-generation and 155 third-generation descendants at high and low risk for depression because of MDD in the first generation were interviewed over 20 years. Probit and Cox proportional hazard models were fitted with generation 2 (G2) or G3 depression as the outcome and parental MDD as the predictor. In G2 and G3, fear- (phobia or panic) and anxiety-related [overanxious or generalized anxiety disorder (GAD)] disorders were examined as potential mediators of increased risk for offspring depression, due to parental MDD.ResultsIn G2, fear-related disorders met criteria for mediating the association between parental MDD and offspring MDD whereas anxiety-related disorders did not. These results were consistent, regardless of the analytic methods used. Further investigation of the mediating effect of fear-related disorders by age of onset of offspring MDD suggests that the mediating effect occurs primarily in adolescent onset MDD. The results for G3 appear to follow similar patterns.ConclusionsThese findings support the separation of anxiety disorders into at least two distinct forms, particularly when examining their role in the etiology of depression.

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