Nardi Antonio E, Valença Alexandre M, Mezzasalma Marco A, Lopes Fabiana L, Nascimento Isabella, Veras Andre B, Freire Rafael C, de-Melo-Neto Valfrido L, Zin Walter A
Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Depress Anxiety. 2006;23(4):236-44. doi: 10.1002/da.20165.
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 (chi(2) = 28.44, df = 1, P<.001) and in 40 (52.6%) patients during the breath-holding test (chi(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 (chi(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 (chi(2) = 18.34, df = 1, P = .028), and had more previous depressive episodes (chi(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.
呼吸及其控制机制可能是与异常焦虑相关的一个重要系统。我们的目的是比较伴有广场恐惧症（DSM-IV）的惊恐障碍（PD）患者在35%二氧化碳（CO₂）试验和屏气试验后发生惊恐发作的患者（CPA组）的人口统计学和临床特征，并将其与在两项试验后均未发生惊恐发作的PD患者（NPA组）进行比较。我们检查了76例PD患者，在1周内对他们进行了35% CO₂试验和屏气试验。在每次试验前后应用焦虑量表。在CO₂试验期间，50例（65.8%）患者诱发了惊恐发作（χ² = 28.44，自由度 = 1，P <.001），在屏气试验期间，40例（52.6%）患者诱发了惊恐发作（χ² = 15.35，自由度 = 1，P =.036）。所有在屏气试验期间发生惊恐发作的患者在CO₂试验期间也发生了惊恐发作（n = 40；CPA组）。26例（34.2%）PD患者在两项呼吸试验后均未发生惊恐发作（NPA组）。CPA组有更多的（χ² = 21.67，自由度 = 1，P =.011）呼吸性PD亚型。在CPA组中，疾病开始得更早（曼-惠特尼检验，P <.001），PD的家族患病率更高（χ² = 18.34，自由度 = 1，P =.028），并且有更多既往抑郁发作（χ² = 23.59，自由度 = 1，P <.001）。我们的数据表明，呼吸性PD亚型与对呼吸激发试验（CO₂和屏气） 的反应之间存在关联。CPA可能被确认为呼吸性PD亚型的一个亚组。
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