Panic disorder and hyperventilation

Abstract

-Respiratory abnormalities are associated with anxiety, particularly with panic attacks. Symptoms such as shortness of breath, "empty-head" feeling, dizziness, paresthesias and tachypnea have been described in the psychiatric and respiratory physiology related to panic disorder. Panic disorder patients exhibit both behaviorally and physiologically abnormal responses to respiratory challenges tests. Objective: We aim to observe the induction of panic attacks by hyperventilation in a group of panic disorder patients (DSM-IV). Method: 13 panic disorder patients and 11 normal volunteers were randomly selected. They were drug free for a week. They were induced to hyperventilate (30 breaths/min) for 3 minutes. Anxiety scales were taken before and after the test. Results: 9 (69.2%) panic disorder patients and one (9.1%) of control subjects had a panic attack after hyperventilating (p< 0.05). Conclusion: The panic disorder group was more sensitive to hyperventilation than normal volunteers. The induction of panic attacks by vonluntary hyperventilation may be a useful and simple test for validating the diagnosis in some specific panic disorder patients.KEY WORDS: panic attack, respiration, anxiety disorder, ventilation. Transtorno do pânico e hiperventilaçãoRESUMO -Distúrbios respiratórios estão associados à ansiedade, especialmente aos ataques de pânico. Sufocamento, sensação de "cabeça leve", tonteira, parestesias e taquipnéia aparecem na descrição psiquiátrica e respiratória do transtorno do pânico. Pacientes com transtorno do pânico apresentam respostas comportamentais e fisiológicas anormais a testes respiratórios. Objetivo: Observamos a indução de ataques de pânico através de hiperventilação em um grupo de pacientes com transtorno do pânico (DSM-IV). Método: Selecionamos de forma randomizada 13 pacientes com transtorno do pânico e 11 voluntários normais. Todos estavam sem medicação há uma semana. Foram induzidos a hiperventilar (30 inspirações/minuto) durante 3 minutos. Escalas de ansiedade foram utilizadas antes e após o teste. Resultados: No grupo com transtorno de pânico, 9 (69,2%) pacientes apresentaram ataque de pânico após a hiperventilação e apenas 1 (9,1%) no grupo controle (p<0,05). Conclusão: Os pacientes com transtorno do pânico foram mais sensíveis à hiperventilação que o grupo controle. A indução de ataques de pânico através da hiperventilação pode ser método útil e simples para validar o diagnóstico em um grupo específico de pacientes com transtorno do pânico.PALAVRAS CHAVE: ataque de pânico, respiração, transtorno de ansiedade, ventilação.One of the features of the description of a panic attack is the physical nature of the symptoms. Patients with panic disorder always begin the description of their disease mentioning either the respiratory system, the heart or the gastrointestinal tract 1 . Symptoms such as shortness of breath,The research was conducted at

Cardiorespiratory Optimal Point: A Submaximal Exercise Variable to Assess Panic Disorder Patients

“…Several studies have investigated respiratory symptoms in PD patients [2], [31], [32], [33] and found that, during PA, respiratory complaints are common, such as dyspnea and tachypnea. Some specific respiratory tests aimed at inducing PA have been used, demonstrating that respiratory maneuvers, such as hyperventilation [34], carbon dioxide inhalation [35] and voluntary apnea [36], may increase anxiety in PD patients and thereby trigger a PA.…”

Hyperventilation in panic disorder patients and healthy first-degree relatives

“…In a preliminary study (19) we observed the induction of panic attacks by hyperventilation in a group of panic disorder patients (DSM-IV). Thirteen panic disorder patients and 11 normal volunteers were randomly selected and induced to hyperventilate (30 Table 2 -Subjective anxiety levels rated by the subjects just before and after hyperventilation (mean ± SD).…”

Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks

“…Hyperventilation provoked a PA in 3/12 PD subjects (25%) (Gorman et al, 1984), and in another study elicited mild fear in 20% of PD subjects (3/15), and no PAs (defined as moderate to strong fear response) (Antony et al, 1997). In other studies using a hyperventilation challenge, PD subjects had a PA (defined as 4 or more symptoms of a PA in the DSM-IV, with at least one cognitive fear symptom) response rate of 46% (6/13) and healthy controls 10% (1/10) in one study (Nardi et al, 1999), and PD response rates of 46% (16/35) compared to response rates of 7% (2/30) in healthy subjects in another study (Nardi et al, 2001). Specific physical symptoms were not reported, nor were objective autonomic and endocrine measures assessed.…”