Associations between age of onset and lifetime history of panic attacks and alcohol use, abuse, and dependence in a representative sample

Objective: The present investigation evaluated associations between lifetime panic attacks and lifetime alcohol use, abuse, and dependence. Specifically, the relations between lifetime panic attacks and alcohol use, abuse, and dependence were examined after controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use. Design and Setting: Data for this study were obtained from a large statewide survey, the Colorado Social Health Survey. Participants were contacted using randomly sampled household addresses (response rate was 72%) and interviews took place in participants' homes. Participants: The study consisted of a representative sample of the Colorado general adult population (n = 4745; 52% women). Main Outcome Measures: The Diagnostic Interview Schedule (American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [3rd ed]. Washington [DC]: Author. 1980) was administered to obtain Axis I diagnoses. Results: After controlling for theoretically relevant variables of comorbid psychopathology and polysubstance use, a lifetime history of panic attacks was significantly associated with alcohol dependence but not alcohol use or abuse. In addition, among participants reporting a lifetime history of both panic attacks and alcohol abuse or dependence, the number of participants for whom panic attacks developmentally preceded the onset of alcohol use problems was significantly greater (85.5%) than the number of participants for whom alcohol use problems preceded the onset of panic attacks (13.4%) or the number of participants for whom these problems developed at the same age (2.2%). Conclusions: These data suggest panic attacks, particularly of early onset, may serve as a risk marker for alcohol dependence. (c) 2006 Elsevier Inc. All rights reserved.