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35% Carbon dioxide and breath‐holding challenge tests in panic disorder: a comparison with spontaneous panic attacks
Author(s) -
Nardi Antonio E.,
Valença Alexandre M.,
Mezzasalma Marco A.,
Lopes Fabiana L.,
Nascimento Isabella,
Veras Andre B.,
Freire Rafael C.,
deMeloNeto Valfrido L.,
Zin Walter A.
Publication year - 2006
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20165
Subject(s) - panic , agoraphobia , panic disorder , anxiety , medicine , anxiety disorder , psychiatry , psychology
Respiration and its control mechanisms may represent an important system involved in abnormal anxiety. Our aim was to compare the demographic and clinical features of patients with panic disorder (PD) with agoraphobia (DSM‐IV) who had a panic attack after both the 35% carbon dioxide (CO 2 ) test and the breath‐holding test (CPA group), and compare them with PD patients who did not have a panic attack after both tests (NPA group). We examined 76 patients with PD who were administered a 35% CO 2 test and a breath‐holding test within a 1‐week interval. Anxiety scales were applied before and after each test. A panic attack was induced in 50 (65.8%) patients during the CO 2 test (χ 2 = 28.44, df = 1, P <.001) and in 40 (52.6%) patients during the breath‐holding test (χ 2 = 15.35, df = 1, P = .036). All patients who had a panic attack during the breath‐holding test also had a panic attack during the CO 2 test ( n = 40; CPA group). Twenty‐six (34.2%) patients with PD did not have a panic attack after both respiratory tests (NPA group). The CPA group had more (χ 2 = 21.67, df = 1, P = .011) respiratory PD subtype. In the CPA group, the disorder started earlier (Mann–Whitney, P <.001), had a higher familial prevalence of PD (χ 2 = 18.34, df = 1, P = .028), and had more previous depressive episodes (χ 2 = 23.59, df = 1, P <.001). Our data suggest that there is an association between respiratory PD subtype and the response to respiratory challenge tests: CO 2 and breath‐holding. The CPA may be confirmed as a subgroup of respiratory PD subtype. Depression and Anxiety 23:236–244, 2006. © 2006 Wiley‐Liss, Inc.