Exercise Avoidance and Impaired Endurance Capacity in Patients with Panic Disorder

Broocks, Andreas; Meyer, Tim; Bandelow, Borwin; George, Annette; Bartmann, Uwe; Rüther, Eckart; Hillmer-Vogel, Ursula

doi:10.1159/000119381

Cited by 61 publications

(46 citation statements)

References 7 publications

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“…[1][2][3] The extent to which their poorer aerobic performances may be related to the actual function of their cardio-respiratory system or affected by psychological variables, such as anxiety levels during fitness testing or catastrophic misinterpretation of physical symptoms has not, however, been satisfactorily clarified; one study showed that high anxiety sensitivity may partly contribute to poor cardiovascular fitness estimation and exercise intolerance in patients with PD. 3 Thus, to evaluate the influence of psychological variables on fitness estimation assessment of patients with PD, we investigated the possible association between their cardiorespiratory response and perceived exertion during submaximal exercise, as well as their state anxiety both before and during exercising, trait anxiety, fear of physical sensations, and fear of autonomic arousal.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory response to physical exercise and psychological variables in panic disorder

Caldirola¹,

Namia

Micieli³

et al. 2011

Rev. Bras. Psiquiatr.

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Objective:To investigate the possible influence of psychological variables on cardiorespiratory responses and perceived exertion of patients with Panic Disorder (PD) during a submaximal exercise test. Method: Ten outpatients with PD and 10 matched healthy subjects walked up on a treadmill slope at a speed of 4 km/h in order to reach 65% of their maximum heart rate. Cardiorespiratory variables were continuously recorded. Before the exercise, the state and trait anxiety (State-Trait Anxiety Inventory scores), fear of physical sensations (Body Sensation Questionnaire scores), and fear of autonomic arousal (Anxiety Sensitivity Index scores) were assessed; during the exercise, levels of anxiety (VAS-A) and exertion (Borg Scale CR 10) were measured. Results: Compared to controls, patients reached earlier the target HR and the ventilatory threshold, showed lower oxygen consumption, higher HR and lower within-subject standard deviations of HR (a measure of cardiac variability). Exertion was also higher, and there was a significant correlation between breathing frequency, tidal volume and HR. No significant associations were found between cardiorespiratory response, perceived exertion, and psychological variables in patients with PD. Conclusion: Although patients with PD presented poor cardiorespiratory fitness and were required to spend more effort during physical exercise, this did not appear to be related to the psychological variables considered. Further studies with larger groups are warranted. ©2011 Elsevier Editora Ltda. All rights reserved. Cardiorespiratory response to physical exercise and psychological variables in panic disorder

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Section: Introductionmentioning

confidence: 99%

Cardiorespiratory response to physical exercise and psychological variables in panic disorder

Caldirola¹,

Namia

Micieli³

et al. 2011

Rev. Bras. Psiquiatr.

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“…In patients with panic disorder, the same oral dose of m-CPP led to marked sensations of anxiety, activation, altered self-reality, depression, dysphoria, and subjective functional deficit, and more than half of the patients experienced panic attacks or acute anxiety very similar to panic attacks (Broocks et al 1998b). At the same time, patients with panic disorder are characterized by exercise avoidance and markedly reduced aerobic fitness (Broocks et al 1997;Martinsen et al 1989;Miyakoda et al 1990;Roth 1989;Roth et al 1986;Taylor et al 1987). Abstinence from exercise seems to be a clinically relevant component of the phobic avoidance behavior.…”

Section: Discussionmentioning

confidence: 99%

Decreased Neuroendocrine Responses to Meta-Chlorophenylpiperazine (m-CPP) but Normal Responses to Ipsapirone in Marathon Runners

Broocks

Meyer²,

George

et al. 1999

Neuropsychopharmacology

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Several clinical studies suggest antidepressive and anxiolytic effects of regular aerobic exercise. To study the effects of exercise on central serotonergic receptor sensitivity, we performed neuroendocrine challenges using oral doses of meta-chlorophenylpiperazine (m-CPP, 0.4 mg/ kg), ipsapirone (0.3 mg/kg) and placebo in 12 marathon runners and 12 healthy controls not practicing regular exercise. After administration of the nonselective serotonergic agonist m-CPP, which exerts a number of wellreproducible effects mainly by means of its action on 5-HT Meta-chlorophenylpiperazine (m-CPP); Ipsapirone Several studies of healthy volunteers have shown a positive effect of endurance training on anxiety, depressive symptoms, self-esteem, concentration, sexual satisfaction, and stress tolerance (de Coverley Veale 1987;Farmer et al. 1988;Hughes 1984;Lennox et al. 1990;MacMahon 1990;Sothman et al. 1992). There is also some evidence that exercise is effective against mild-to-moderate depression and against anxiety disorders (Doyne et al. 1987;Greist et al. 1979;Martinsen et al. 1985;McCann and Holmes 1984;Pappas et al. 1990;Sexton et al. 1989). Research in sports medicine has focused on physiological and immunological consequences of exercise, and little is known about changes in central neurotransmitter function associated with acute or regular endurance training.Several lines of evidence suggest that motor activity affects central serotonin metabolism. In the cerebrospinal fluid of depressed patients, the concentration of the serotonin metabolite 5-HIAA was significantly higher after 4 hours of motor activity than in the same patients after bed rest (Post et al. 1973). Aerobic exercise causes a rise of free fatty acids Fischer et al. From the Department of Psychiatry, University of Göttingen, Göt-tingen, Germany (AB, DM, BB, GH, UB, ER), the Department of Neurology (AG), University of Würzburg, Würzburg, Germany; the Department of Clinical Pharmacology (CHG), Department of Sports Medicine (UH-V), University of Göttingen, Göttingen, Germany; Institute of Sports and Preventive Medicine (TM), University of Saarbrücken, Saarbrücken, Germany.Address correspondence to: Dr. A. Broocks, The Department of Psychiatry, University of Göttingen, von-Siebold-Strasse 5, D-37075 Göttingen, Germany.Received 28 October 1997; revised 12 March 1998; accepted 13 April 1998. N EUROPSYCHOPHARMACOLOGY 1999 -VOL . 20 , NO . 2 Decreased Serotonergic Responsiveness in Marathon Runners 151 1991), which displace free tryptophan (TRP) from its plasma-protein-binding sites (Blomstrand et al. 1988;Chaouloff et al. 1986). This leads to an increase of free TRP in relation to other large neutral amino acids (LNAA) (Chaouloff et al. 1989). Because the TRP influx into the brain correlates with the TRP/LNAA plasma ratio (Fernstrom and Wurtman 1971;Wurtman and Fernstrom 1976), exercise leads to a higher precursor availability in the brain, which, in turn, stimulates 5-HT synthesis (Broocks et al. 1989;Chaouloff 1997). Data from animal studies show th...

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“…During the 3-minute recovery phase, beginning immediately, speed was decreased and maintained for 1 minute per decrement. Perceived exertion was evaluated by the patient at each stage of the exercise test on a 15-point linear scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) as described by Borg. 37 …”

Section: Methodsmentioning

confidence: 99%

“…6 Alternatively, simpler explanations may have been overlooked. Aerobic exercise may be avoided by many PD patients 7 and sedentariness is known to be associated with increased cardiovascular risk. 8 In addition, exercise may induce acute panic attacks (PAs) 9,10 or increase subjective anxiety in patients with PD more than in other people.…”

Section: Introductionmentioning

confidence: 99%

Panic disorder and exercise avoidance

Muotri

Bernik

2014

Rev. Bras. Psiquiatr.

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Objectives: 1) To identify whether patients with panic disorder in general and those with the respiratory subtype in particular actively avoid exercise; 2) to investigate physiological differences in cardiopulmonary function parameters in patients with panic disorder in general, patients with the respiratory subtype of panic disorder, and healthy controls upon exercise challenge. Methods: Patients with panic disorder were classified as having either the respiratory or the nonrespiratory subtype. Both groups were compared to controls in terms of exercise avoidance patterns and performance on cardiopulmonary exercise testing. Results: Patients with panic disorder exhibited higher exercise avoidance scores and worse performance on cardiopulmonary exercise testing as compared with controls. No differences were found between patients with the respiratory and non-respiratory subtypes. Conclusions: Exercise avoidance is present in panic disorder and is associated with poorer performance on cardiopulmonary exercise testing. These findings are not limited to patients with the respiratory subtype of the disorder.

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Exercise Avoidance and Impaired Endurance Capacity in Patients with Panic Disorder

Cited by 61 publications

References 7 publications

Cardiorespiratory response to physical exercise and psychological variables in panic disorder

Cardiorespiratory response to physical exercise and psychological variables in panic disorder

Decreased Neuroendocrine Responses to Meta-Chlorophenylpiperazine (m-CPP) but Normal Responses to Ipsapirone in Marathon Runners

Panic disorder and exercise avoidance

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