Ventilatory Physiology of Children and Adolescents With Anxiety Disorders

Pine, Daniel S.; Coplan, Jeremy D.; Papp, Laszlo A.; Klein, Rachel G.; Martı́nez, José M.; Kovalenko, Pavel; Tancer, Nancy K.; Moreau, Donna; Dummit, E. Steven; Shaffer, David; Klein, Donald F.; Gorman, Jack M.

doi:10.1001/archpsyc.55.2.123

Cited by 76 publications

(58 citation statements)

References 50 publications

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“…Neurobiological studies of pediatric anxiety have been limited to OCD, with the exception of recent work by Pine and colleagues examining ventilatory physiology in children and adolescents with anxiety disorders. Anxious children and adolescents had higher respiratory rates and minute ventilation on CO 2 challenge and more variable breathing patterns than healthy controls; similar results have been found in studies of adult panic disorder [Pine et al, 1998b].…”

Section: Biologicalsupporting

confidence: 82%

Relation between anxiety and depressive disorders in childhood and adolescence

2001

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Current research indicates that there is a strong relationship between pediatric anxiety disorders and depression. Assessment measures show high rates of correlation between depression and anxiety and much of the overlap may be related to a common domain of negative affectivity. Anxious youth and depressed youth share a cognitive style marked by a negative bias in information processing. Anxiety disorders and depression are frequently comorbid in children and adolescents. About 25-50% of depressed youth have comorbid anxiety disorders and about 10-15% of anxious youth have depression. Twin and family studies have demonstrated that pediatric anxiety disorders and depression likely share some common genetic factors or influences. Selective serotonin reuptake inhibitors and cognitive-behavioral therapy have been shown in randomized controlled trials to be efficacious for both pediatric depression and anxiety disorders. Integrating the treatment literature with studies of phenomenology, biology and genetics indicates that pediatric anxiety disorders and depression may share a genetically determined neurobiological component that could involve neural circuits that include or are modulated by serotonergic neurons. This component could contribute to the negative affective temperament that appears to be common in both pediatric depression and anxiety disorders.

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Section: Biologicalsupporting

confidence: 82%

Relation between anxiety and depressive disorders in childhood and adolescence

2001

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“…Moreover, these results indicate that ovarian hormones do not necessarily protect against the effects of early life stress on respiratory control development. In light of the present data, we propose that, with such enhancement of the CO 2 chemoreflex, NMS rats may be more susceptible to develop respiratory disorders associated with neural control dysfunction such as respiratory instability during sleep or panic attacks (10,13,19,28,32). Should data support this hypothesis, NMS may be a valuable model to understand these pathologies.…”

Section: Nms and Sex-specific Plasticity Of The Hypercapnic Ventilatomentioning

confidence: 57%

Neonatal maternal separation induces sex-specific augmentation of the hypercapnic ventilatory response in awake rat

Genest

Gulemetova²,

Laforest³

et al. 2007

Journal of Applied Physiology

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Genest S-E, Gulemetova R, Laforest S, Drolet G, Kinkead R. Neonatal maternal separation induces sex-specific augmentation of the hypercapnic ventilatory response in awake rat. J Appl Physiol 102: 1416 -1421, 2007. First published December 21, 2006; doi:10.1152/japplphysiol.00454.2006.-Neonatal maternal separation (NMS) is a form of stress that exerts persistent, sex-specific effects on the hypoxic ventilatory response. Adult male rats previously subjected to NMS show a 25% increase in the response, whereas NMS females show a response 30% lower than controls (8). To assess the extent to which NMS affects ventilatory control development, we tested the hypothesis that NMS alters the ventilatory response to hypercapnia in awake, unrestrained rats. Pups subjected to NMS were placed in a temperature-and humidity-controlled incubator 3 h/day for 10 consecutive days (P3 to P12). Control pups were undisturbed. At adulthood (8 to 10 wk old), rats were placed in a plethysmography chamber for measurement of ventilatory parameters under baseline and hypercapnic conditions (inspired CO2 fraction ϭ 0.05). After 20 min of hypercapnia, the minute ventilation response measured in NMS males was 47% less than controls, owing to a lower tidal volume response (22%). Conversely, females previously subjected to NMS showed minute ventilation and tidal volume responses 63 and 18% larger than controls respectively. Although a lower baseline minute ventilation contributes to this effect, the higher minute ventilation/ CO2 production response observed in NMS females suggests a greater responsiveness to CO2/H ϩ in this group. We conclude that NMS exerts sex-specific effects on the hypercapnic ventilatory response and that the neural mechanisms affected by NMS likely differ from those involved in the hypoxic chemoreflex.control of breathing; plasticity; hypercapnia; sexual dimorphism THE NEONATAL ENVIRONMENT is critical to proper development of neurophysiological function. The formation and fine tuning of neural circuits during early life require adequate sensory guidance, and conditions providing excessive or insufficient levels of stimulation can disrupt system development and compromise their subsequent performance throughout life. The olfactory, tactile, and auditory stimuli that the mother provides her offspring following birth are among the most potent environmental factors contributing to the "neonatal programming" of neural circuits (12,22). Although the life-long consequences of disrupting motherpup interactions have been mainly associated with behavioral and neuroendocrine dysfunction (1, 2, 20), less is known about the impact of mother-pup interaction on other homeostatic functions such as cardiorespiratory regulation. Accordingly, we showed that neonatal maternal separation (NMS) disrupts cardiorespiratory responses to moderate hypoxia in a persistent and sex-specific fashion (8,16). In addition to eliciting the well described enhancement of basal hypothalamo-pituitary-adrenal axis function in rats (34; for review see Ref. 5), we...

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“…Two studies in more than 100 children and adolescents demonstrated such perturbations in separation anxiety disorder but not social anxiety disorder. [127][128][129][130] Moreover, a series of epidemiological studies also link the diagnosis of separation anxiety disorder to various conditions, such as asthma, that produce respiratory perturbations. [131][132][133][134] Although findings in this area probably appear stronger than for either family-based or longitudinal studies, even here, support for grouping the two entities is only moderate.…”

Section: Developmental Expressions Of Pd Diathesismentioning

confidence: 99%

Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V

et al. 2010

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This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.

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Ventilatory Physiology of Children and Adolescents With Anxiety Disorders

Abstract: These findings on the association between ventilatory physiology and anxiety disorders in children and adolescents are consistent with results from studies of adults with panic disorder.

Cited by 76 publications

References 50 publications

Relation between anxiety and depressive disorders in childhood and adolescence

Relation between anxiety and depressive disorders in childhood and adolescence

Neonatal maternal separation induces sex-specific augmentation of the hypercapnic ventilatory response in awake rat

Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V

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