Hyperventilation Symptoms are Linked to a Lower Perceived Health in Asthma Patients

Ritz, Thomas; Rosenfield, David; Meuret, Alicia E.; Bobb, Carol; Steptoe, Andrew

doi:10.1007/s12160-007-9014-7

Cited by 30 publications

(22 citation statements)

References 45 publications

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“…(14) It is possible that hypocapnia induced by hyperventilation creates symptoms that asthma patients cannot control by using asthma medication, and that their perceived control over the management of their disease is therefore impaired. (16) Clinical anxiety and panic manifestations affect symptom perception and asthma management directly, due to the effects of anxiety symptoms such as hyperventilation, and indirectly, due to changes in self-management behavior and physician response. Therefore, behavioral interventions designed to improve quality of life and treatment response among such patients should be tested.…”

Section: Introductionmentioning

confidence: 99%

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

et al. 2009

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Multiple respiratory abnormalities can be found in anxiety disorders, especially in panic disorder (PD). Individuals with PD experience unexpected panic attacks, characterized by anxiety and fear, resulting in a number of autonomic and respiratory symptoms. Respiratory stimulation is a common event during panic attacks. The respiratory abnormality most often reported in PD patients is increased CO 2 sensitivity, which has given rise to the hypothesis of fundamental abnormalities in the physiological mechanisms that control breathing in PD. There is evidence that PD patients with dominant respiratory symptoms are more sensitive to respiratory tests than are those who do not manifest such symptoms, and that the former group constitutes a distinct subtype. Patients with PD tend to hyperventilate and to panic in response to respiratory stimulants such as CO 2 , triggering the activation of a hypersensitive fear network. Although respiratory physiology seems to remain normal in these subjects, recent evidence supports the idea that they present subclinical abnormalities in respiration and in other functions related to body homeostasis. The fear network, composed of the hippocampus, the medial prefrontal cortex, the amygdala and its brain stem projections, might be oversensitive in PD patients. This theory might explain why medication and cognitive-behavioral therapy are both clearly effective. Our aim was to review the relationship between respiration and PD, addressing the respiratory subtype of PD and the hyperventilation syndrome, with a focus on respiratory challenge tests, as well as on the current mechanistic concepts and the pharmacological implications of this relationship.Keywords: Panic disorder; Anxiety; Respiration; Hyperventilation; Carbon dioxide. ResumoMúltiplas anormalidades respiratórias podem ser encontradas em pacientes com transtornos de ansiedade, particularmente no transtorno de pânico (TP). Indivíduos com TP experimentam ataques de pânico inesperados, caracterizados por ansiedade, medo e diversos sintomas autonômicos e respiratórios. A estimulação respiratória é um fenômeno comum durante os ataques de pânico. A anormalidade respiratória mais citada em pacientes com TP é a sensibilidade aumentada para o CO 2 , que originou a hipótese de uma disfunção fundamental nos mecanismos fisiológicos de controle da respiração no TP. Há evidências de que pacientes com TP com sintomas respiratórios predominantes são mais sensíveis a testes respiratórios do que aqueles sem a manifestação de tais sintomas, representando um subtipo distinto. Pacientes com TP tendem a hiperventilar e a reagir com pânico como resposta a estimulantes respiratórios como o CO 2 , gerando uma ativação de um circuito de medo hipersensível. Apesar de a fisiologia respiratória desses pacientes permanecer normal, algumas evidências recentes apontam a presença de disfunções subclínicas na respiração e em outras funções relacionadas à homeostase corporal. O circuito do medo, composto pelo hipocampo, córtex pré-frontal medial, amígd...

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Section: Introductionmentioning

confidence: 99%

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

et al. 2009

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“…While the study used objective detection of inhaler usage, there was no objective measure of asthma symptomology. Moreover, it may be possible that when participants are exposed to stress, their perception of asthma symptoms may become hypersensitive (Feldman, Siddique, Thompson, & Lehrer, 2009; Lavoie et al, 2005; Thomas Ritz, Rosenfield, Meuret, Bobb, & Steptoe, 2008). Child asthma history was also self-reported without parent or physician verification.…”

Section: Discussionmentioning

confidence: 99%

Momentary Assessment of Psychosocial Stressors, Context, and Asthma Symptoms in Hispanic Adolescents

Dunton

Dzubur

et al. 2015

Behav Modif

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Objective The current study used a novel real-time data capture strategy, Ecological Momentary Assessment (EMA), to examine whether within-day variability in stress and context leads to exacerbations in asthma symptomatology in the everyday lives of ethnic minority adolescents. Methods Low-income, Hispanic adolescents (N = 20) (7th–12th grade) (54% male) with chronic asthma completed seven days of EMA on smartphones, with an average of five assessments per day during non-school time. EMA surveys queried about where (e.g., home, outdoors) and with whom (e.g., alone, with friends) participants were at the time of the prompt. EMA surveys also assessed over the past few hours whether participants had experienced specific stressors (e.g., being teased, arguing with anyone), asthma symptoms (e.g., wheezing, coughing), or used an asthma inhaler. Multilevel models tested the independent relations of specific stressors, and context to subsequent asthma symptoms adjusting for age, gender, and chronological day in the study. Results Being outdoors and experiencing disagreements with parents, teasing, or arguing were associated with more severe self-reported asthma symptoms in the next few hours (p’s < .05). Being alone and having too much to do were unrelated to the experience of subsequent self-reported asthma symptoms. Conclusions Using a novel real-time data capture strategy, results provide preliminary evidence that being outdoors and experiencing social stressors may induce asthma symptoms in low-income Hispanic children and adolescents with chronic asthma. The results of this preliminary study can serve as the basis for larger epidemiological and intervention studies.

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“…We used the 36 item version, which has been thoroughly validated (Lemaigre et al, 2005;Cooper et al, 2007;De Peuter et al, 2007;Deshmukh et al, 2008;Ritz et al, 2008;Jonathan M Feldman et al, 2009;Meuret and Ritz, 2010;Chung et al, 2012), and demonstrated good reliability in the current sample for all five subscales including hyperventilation (α=.82), bronchoconstriction (α=.88), irritability (α=.87), panic/fear (α=.94), and fatigue (α=.94).…”

Section: Methodsmentioning

confidence: 99%

Posttraumatic stress disorder following asthma attack: the role of agency beliefs in mediating psychiatric morbidity

Wagner

Hoelterhoff

Chung

2017

Journal of Mental Health

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Any item and its associated metadata held in the University of Cumbria's institutional repository Insight (unless stated otherwise on the metadata record) may be copied, displayed or performed, and stored in line with the JISC fair dealing guidelines (available here) for educational and not for profit activities provided that• the authors, title and full bibliographic details of the item are cited clearly when any part of the work is referred to verbally or in the written form• a hyperlink/URL to the original Insight record of that item is included in any citations of the work • the content is not changed in any way• all files required for usage of the item are kept together with the main item file. You may not• sell any part of an item• refer to any part of an item without citation • amend any item or contextualise it in a way that will impugn the creator's reputation• remove or alter the copyright statement on an item.The full policy can be found here. Alternatively contact the University of Cumbria Repository Editor by emailing insight@cumbria.ac.uk. AimsTo determine the prevalence of PTSD following asthma attack, and investigate whether agency beliefs mediate PTSD and comorbid psychiatric symptoms in this population. MethodWe recruited 110 adults with asthma from online peer support forums. Participants completed the Asthma Symptom Checklist, PTSD Checklist, GHQ-28, General Self-Efficacy scale, and Multidimensional Health Locus of Control scale. Results20% of our sample met criteria for PTSD. Regression results indicated that higher asthma severity significantly predicted PTSD and psychiatric co-morbidity. Lower selfefficacy significantly predicted PTSD symptoms while controlling for asthma severity, however Locus of Control (LoC) did not improve the model further. Self-efficacy, but not LoC, significantly partially mediated the effect of asthma severity on PTSD severity and psychiatric co-morbidity. Conclusions 2Pos$rauma)c Stress Disorder following asthma a$ack PTSD and other psychiatric symptoms in asthma populations are mediated in part by self-efficacy. Safeguarding and improving self-efficacy in this population is an important area for future research and intervention. Declaration of interestThe authors have no conflict of interest to declare.

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Hyperventilation Symptoms are Linked to a Lower Perceived Health in Asthma Patients

Cited by 30 publications

References 45 publications

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

Respiratory manifestations of panic disorder: causes, consequences and therapeutic implications

Momentary Assessment of Psychosocial Stressors, Context, and Asthma Symptoms in Hispanic Adolescents

Posttraumatic stress disorder following asthma attack: the role of agency beliefs in mediating psychiatric morbidity

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