Respiratory disorders as a possible predisposing factor for panic disorder

Verburg, Kees; Griez, Eric; Meijer, Jaap; Pols, Henk

doi:10.1016/0165-0327(94)00083-l

Cited by 66 publications

(30 citation statements)

References 16 publications

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“…[22][23][24][25] The current pattern of results does imply that once PDA manifests, fear of bodily sensations linked to anxiety may be intensified and become central to the manifestation of PDA, at least relative to social anxiety. In summary, the present results suggest that elevated health anxiety or hypochondriacal tendencies, [37,38] as well as history of physical diseases, [28,29,30] contribute to the development of PDA relative to social phobia in women over a 17-month interval of time. Fear of bodily sensations is not a specific predictor of PDA but is a specific marker of PDA once manifest, relative to social phobia.…”

Section: Discussionmentioning

confidence: 78%

“…Indirect support for the role of health anxiety in PDA derives from a number of studies indicating heightened occurrence of medical illness (particularly, respiratory disturbance) in the histories of individuals with panic disorder/agoraphobia, [28][29][30] including reported elevations in parental modeling, and/or reinforcement, of sick role behaviors. [31][32][33][34][35] According to the cognitive model of health anxiety, such experiences would be likely to contribute to health anxiety.…”

Section: Introductionmentioning

confidence: 98%

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Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study

et al. 2010

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Section: Discussionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 98%

Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study

et al. 2010

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“…Briggs et al [1993], using factor and cluster analysis, found that the group of patients with PD with prominent respiratory symptoms had more spontaneous panic attacks and better responses to imipramine, whereas patients from the NRS had more situational panic attacks and better responses to alprazolam. Studies showed that patients with prominent respiratory symptoms associated with 35% CO 2 sensitivity had a significantly longer illness duration of PD, reported more past traumatic suffocation experiences and respiratory diseases, and were more likely to be heavy smokers than were patients without respiratory symptoms [Biber and Alkin, 1999;Bouwer and Stein, 1997;Valenca et al, 2002;Verburg et al, 1995]. It seems that RS was a more severe and disabling type of PD.…”

Section: Discussionmentioning

confidence: 95%

Panic disorder subtypes: further clinical differences

Onur¹,

Alkın²,

Tural³

2007

Depress. Anxiety

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Panic disorder (PD) is a heterogeneous phenomenon with respect to symptom profile. Most studies agree that a group of patients with prominent respiratory symptoms emerged as a distinct PD subtype. In this study we compared a range of clinical features associated with PD and agoraphobia in patients with respiratory (RS) and nonrespiratory (NRS) subtypes of PD. The participants were 124 patients with PD (79 women and 45 men), with or without agoraphobia, diagnosed by DSM-IV criteria. Following the observer-rated Panic Disorder Severity Scale assessment, subjects completed self-report measures, including the Anxiety Sensitivity Index (ASI), Panic-Agoraphobia Scale; the Beck Anxiety Inventory; and the Panic-Agoraphobic Spectrum Scale (PAS-SR). Multivariate analysis of variance (MANOVA) showed significant group differences [Pillai's trace = 0.95, F (5, 118)(=)2.48, P = .036]. Patients in RS group had higher mean total scores on the ASI (F = 5.00, df = 1, P = .027) and PAS-SR (F = 11.23, df = 1, P = .001) than patients in NRS group. Also, patients with RS attained higher scores than patients with NRS on four domains of PAS-SR (panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking). A descriptive discriminant analysis of the data correctly identified 69.4% of the patient group in general and 86.1% of RS group (Wilks's lambda = 0.87, df = 8, P = .048). The significant discriminating factors of the RS and NRS groups were domains of panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking. Our findings suggest that anxiety sensitivity and panic-agoraphobic spectrum symptoms might be particularly relevant to understanding subtypes of PD.

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“…The respiratory subtype has been shown to be associated with increased familial risk of PD (Horwath et al, 1997;Nardi et al, 2003Nardi et al, , 2006a, to be more common among heavy smokers, to have a longer duration and major severity of illness (Biber and Alkin, 1999), and to have a lower resting end-tidal pCO 2 (Moynihan and Gevirtz, 2001) and a higher sensitivity to CO 2 inhalation (Biber and Alkin, 1999;Valenca et al, 2002;Abrams et al, 2006;Nardi et al, 2006a, b). Other clinical features displayed by PD patients with the respiratory subtype include a later onset of the disease and a faster response to nortriptyline (Nardi et al, 2003(Nardi et al, , 2006a, more past traumatic suffocation experiences and respiratory diseases (Bouwer and Stein, 1997;Verburg et al, 1995), higher levels of anxiety sensitivity, and more panic-agoraphobic spectrum symptoms (Onur et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Carbon Dioxide-Induced Emotion and Respiratory Symptoms in Healthy Volunteers

Colasanti

Salamon

Schruers

et al. 2008

Neuropsychopharmacol

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A number of evidences have established that panic and respiration are closely related. Clinical studies indicated that respiratory sensations constitute a discrete cluster of panic symptoms and play a major role in the pathophysiology of panic. The aim of the present study was to explore the phenomenology of an experimental model of panic in healthy volunteers based on the hypothesis that: (1) we can isolate discrete clusters of panic symptoms, (2) respiratory symptoms represent a distinct cluster of panic symptoms, and (3) respiratory symptoms are the best predictor of the subjective feeling of panic, as defined in the DSM IV criteria.Sixty-four healthy volunteers received a double inhalation of four mixtures containing 0, 9, 17.5 and 35% CO 2, respectively, in a double-blind, cross-over, random design. An electronic visual analog scale and the Panic Symptom List (PSL) were used to assess subjective 'fear/discomfort' and panic symptoms, respectively. Statistical analyses consisted of Spearman's correlations, a principal component factor analysis of the 13 PSL symptoms, and linear regressions analyses.The factor analysis extracted three clusters of panic symptoms: respiratory, cognitive, and neurovegetative (r 2 ¼ 0.65). Respiratory symptoms were highly related to subjective feeling of fear/discomfort specifically in the CO 2 -enriched condition. Moreover, the respiratory component was the most important predictor of the subjective feeling of 'fear/discomfort' (b ¼ 0.54).The discrete clusters of symptoms observed in this study were similar to those elicited in panic attacks naturally occurring in patients affected by panic disorder. Consistent with the idea that respiration plays a crucial role in the pathophysiology of panic, we found that respiratory symptoms were the best predictors the subjective state defined in the DSM IV criteria for panic.

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Respiratory disorders as a possible predisposing factor for panic disorder

Cited by 66 publications

References 16 publications

Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study

Health anxiety and fear of fear in panic disorder and agoraphobia vs. social phobia: a prospective longitudinal study

Panic disorder subtypes: further clinical differences

Carbon Dioxide-Induced Emotion and Respiratory Symptoms in Healthy Volunteers

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