Cardio‐respiratory and other symptom clusters in panic disorder

Bandelow, Borwin; Amering, Michaela; Benkert, Otto; Marks, Isaac; Nardi, Antônio Egídio; Osterheider, Michael; Tannock, Charles; Tremper, Jan; Versiani, Márcio

doi:10.1002/(sici)1522-7154(1996)2:2<99::aid-anxi7>3.3.co;2-d

Cited by 7 publications

(7 citation statements)

References 9 publications

(10 reference statements)

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“…The results confirmed earlier findings of a direct pharmacological effect of ethanol on PD. PD subtypes have been described in the literature [Bandelow et al, 1996;Briggs et al, 1993], and our data add new strength to this differentiation. Briggs et al [1993] have studied the description of the last and most severe panic attack of 1,108 patients with PD, who were divided in two groups according to the presence or absence of prominent respiratory symptoms.…”

Section: Discussionsupporting

confidence: 73%

35% Carbon dioxide and breath-holding challenge tests in panic disorder: a comparison with spontaneous panic attacks

et al. 2006

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Respiration and its control mechanisms may represent an important system involved in abnormal anxiety. Our aim was to compare the demographic and clinical features of patients with panic disorder (PD) with agoraphobia (DSM-IV) who had a panic attack after both the 35% carbon dioxide (CO(2)) test and the breath-holding test (CPA group), and compare them with PD patients who did not have a panic attack after both tests (NPA group). We examined 76 patients with PD who were administered a 35% CO(2)test and a breath-holding test within a 1-week interval. Anxiety scales were applied before and after each test. A panic attack was induced in 50 (65.8%) patients during the CO(2)test (chi(2) = 28.44, df = 1, P<.001) and in 40 (52.6%) patients during the breath-holding test (chi(2) = 15.35, df = 1, P = .036). All patients who had a panic attack during the breath-holding test also had a panic attack during the CO(2)test (n = 40; CPA group). Twenty-six (34.2%) patients with PD did not have a panic attack after both respiratory tests (NPA group). The CPA group had more (chi(2) = 21.67, df = 1, P = .011) respiratory PD subtype. In the CPA group, the disorder started earlier (Mann-Whitney, P<.001), had a higher familial prevalence of PD (chi(2) = 18.34, df = 1, P = .028), and had more previous depressive episodes (chi(2) = 23.59, df = 1, P<.001). Our data suggest that there is an association between respiratory PD subtype and the response to respiratory challenge tests: CO(2)and breath-holding. The CPA may be confirmed as a subgroup of respiratory PD subtype.

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Section: Discussionsupporting

confidence: 73%

35% Carbon dioxide and breath-holding challenge tests in panic disorder: a comparison with spontaneous panic attacks

et al. 2006

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“…Panic disorder subtypes have been described in the literature. 12,14 Briggs et al 12 studied the description of the last and most severe panic attack of 1,108 panic disorder patients, which were divided into two groups according to the presence or absence of conspicuous respiratory symptoms. They found that the group which had conspicuous respiratory symptoms had more spontaneous panic attacks and better responses to imipramine, while the patients from the nonrespiratory subgroup had more situational panic attacks and better responses with alprazolam.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic response to benzodiazepine in panic disorder subtypes

et al. 2003

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“…Subjects reporting four or more of these signs and symptoms (mainly fear of dying, chest pain/discomfort, dyspnea, numbness, and choking; n=163) tended to develop spontaneous PAs more frequently than those patients with fewer symptoms. 44 In a Japanese sample (n=207), 15 clinical signs and symptoms (13 main symptoms including agoraphobia and anticipatory anxiety) were evaluated as present or absent. A principal component factor analysis revealed three clusters: cluster A comprised dyspnea, sweating, choking, nausea, and flushes/chills; cluster B included dizziness, palpitations, trembling or shaking, depersonalization, agoraphobia, and anticipatory anxiety; and cluster C encompassed paresthesia, chest pain, fear of dying, and fear of going crazy.…”

Section: Analysis Of Pd Clustersmentioning

confidence: 99%

“…Shortness of breath and choking were the main symptoms representing the respiratory factor. 52 Indeed, these symptoms were included in the respiratory cluster in all studies, 5,7,[43][44][45][46][47][48][49][50][51][52] except that of Segui et al 47 Table 1 shows the main findings related to the aforementioned studies, while Table 2 lists the sign-and-symptom profile of the cluster most representative of respiratory-related symptoms.…”

Section: Analysis Of Pd Clustersmentioning

confidence: 99%

Panic disorder respiratory subtype: psychopathology and challenge tests – an update

Okuro

Freire

Zin

et al. 2020

Braz. J. Psychiatry

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Panic disorder (PD) pathophysiology is very heterogeneous, and the discrimination of distinct subtypes could be very useful. A subtype based on respiratory symptoms is known to constitute a specific subgroup. However, evidence to support the respiratory subtype (RS) as a distinct subgroup of PD with a well-defined phenotype remains controversial. Studies have focused on characterization of the RS based on symptoms and response to CO 2 . In this line, we described clinical and biological aspects focused on symptomatology and CO 2 challenge tests in PD RS. The main symptoms that characterize RS are dyspnea (shortness of breath) and a choking sensation. Moreover, patients with the RS tended to be more responsive to CO 2 challenge tests, which triggered more panic attacks in this subgroup. Future studies should focus on discriminating respiratory-related clusters and exploring psychophysiological and neuroimaging outcomes in order to provide robust evidence to confirm RS as a distinct subtype of PD.How to cite this article: Okuro RT, Freire RC, Zin WA, Quagliato LA, Nardi AE. Panic disorder respiratory subtype: psychopathology and challenge tests -an update. Braz J Psychiatry. 2020;00:000-000. http://dx.

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Cardio‐respiratory and other symptom clusters in panic disorder

Cited by 7 publications

References 9 publications

35% Carbon dioxide and breath-holding challenge tests in panic disorder: a comparison with spontaneous panic attacks

35% Carbon dioxide and breath-holding challenge tests in panic disorder: a comparison with spontaneous panic attacks

Therapeutic response to benzodiazepine in panic disorder subtypes

Panic disorder respiratory subtype: psychopathology and challenge tests – an update

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