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A latent class approach to the external validation of respiratory and non-respiratory panic subtypes

Published online by Cambridge University Press:  16 August 2011

R. Roberson-Nay ,
S. J. Latendresse  and
K. S. Kendler
R. Roberson-Nay*
Affiliation:
Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, P.O. Box 980489, Richmond, VA 23298, USA
S. J. Latendresse
Affiliation:
Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, P.O. Box 980489, Richmond, VA 23298, USA
K. S. Kendler
Affiliation:
Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, P.O. Box 980489, Richmond, VA 23298, USA
*
*Address for correspondence: R. Roberson-Nay, Ph.D., Department of Psychiatry, Virginia Commonwealth University, Virginia Institute for Psychiatric and Behavioral Genetics, P.O. Box 980489, Richmond, VA 23298, USA. (Email: rrobersonnay@vcu.edu)
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Abstract

Background

The phenotypic variance observed in panic disorder (PD) appears to be best captured by a respiratory and non-respiratory panic subtype. We compared respiratory and non-respiratory panic subtypes across a series of external validators (temporal stability, psychiatric co-morbidity, treatment response) to determine whether subtypes are best conceptualized as differing: (1) only on their symptom profiles with no other differences between them; (2) on a quantitative (i.e. severity) dimension only; or (3) qualitatively from one another.

Method

Data from a large epidemiological survey (National Epidemiologic Survey on Alcohol and Related Conditions) and a clinical trial (Cross-National Collaborative Panic Study) were used. All analytic comparisons were examined within a latent class framework.

Results

High temporal stability of panic subtypes was observed, particularly among females. Respiratory panic was associated with greater odds of lifetime major depression and a range of anxiety disorders as well as increased treatment utilization, but no demographic differences. Treatment outcome data did not suggest that the two PD subtypes were associated with differential response to either imipramine or alprazolam.

Conclusions

These data suggest that respiratory and non-respiratory panic represent valid subtypes along the PD continuum, with the respiratory variant representing a more severe form of the disorder.

Keywords

External validationlatent classpanic disorderrespiratorystabilitysubtypes

Information

Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 3 , March 2012 , pp. 461 - 474
Copyright
Copyright © Cambridge University Press 2011

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