Detecting Panic Disorder in Children
February 3, 2014
The Wall Street Journal — Recurring chest pain unrelated to heart problems may be an important — but often overlooked — symptom of panic attacks in children and teens, according to a study by researchers at Ben-Gurion University of the Negev in the current issue of Child Psychiatry & Human Development.
Adults with chronic panic attacks, called panic disorder, often report symptoms of non-cardiac chest pain. Complaints of non-cardiac chest pain are common in pediatric patients but few children and adolescents are treated for panic disorder, possibly because they have difficulty articulating the intense feelings of panic, researchers said.
People with panic disorder have sudden and repeated attacks, characterized by a fear of disaster or of losing control even when there is no real danger, according to the National Institute of Mental Health.
The study’s authors said children with non-cardiac chest pain should undergo psychiatric screening, as panic attacks at a young age are associated with a higher rate of health complications and inability to function normally as they get older.
The BGU research team recruited 132 children and adolescents with complaints of chest pain from a pediatric emergency department and cardiology clinics in New York City.
The subjects, ages 8 to 17 years old, underwent medical examinations, including electrocardiograms and echocardiograms to assess heart function and heart structure. Researchers rated anxiety and mood disorders in the children from 0 (absent) to 8 (severe) based on separate interviews with the children and parents conducted after the exams.
Panic disorder, a score of 4 or greater, was diagnosed in 20.5 percent of the children and 12 percent had scores of 3. The children were 13 years-old on average when they first experienced panic attacks and 63 percent were girls.
Chest pain as a panic symptom was reported by 89 percent of subjects with panic disorder and had been present for about 11 months.
Three subjects with panic disorder, who were under 13, reported chest pain unrelated to panic attacks, suggesting children might have difficulty distinguishing chest pain from other symptoms such as heart palpitations, researchers said.
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