Nardi Antonio E, Valença Alexandre M, Mezzasalma Marco A, Levy Sandra P, Lopes Fabiana L, Nascimento Isabella, Freire Rafael C, Veras Andre B, Zin Walter A
Laboratory of Panic and Respiration, Federal University of Rio de Janeiro, Brazil.
Psychiatry Res. 2006 Jun 15;142(2-3):201-8. doi: 10.1016/j.psychres.2005.07.032. Epub 2006 Apr 25.
Our aim was to compare the demographic and psychopathological features of panic disorder (PD) patients who underwent hyperventilation and breath-holding challenge tests, and to describe the features of patients who had a panic attack after both tests versus those patients who did not experience panic after either test. Eighty-five PD patients were induced to hyperventilate (30 breaths/min) for 4 min, and a week later to hold their breath for as long as possible four times with a 2-min interval in between. Anxiety scales were applied before and after the tests. Patients who responded with a panic attack to both tests (BPA, n = 25) were compared with patients who experienced spontaneous panic attacks but did not panic in response to the two tests (NPA, n = 16). The BPA group had a significantly higher presence of respiratory symptoms during a panic attack. The criteria for the respiratory PD subtype were fulfilled in 18 (72.0%) BPA patients and in 6 (37.5%) NPA patients. The BPA patients had a later onset of panic disorder and a higher familial prevalence of PD. Our data suggest that there is a distinction between PD patients who were sensitive to both hyperventilation and breath-holding tests and PD patients who were not affected by the challenge tests. The panic attack may be a final common pathway for different types of stimuli, and respiratory tests may characterize different PD subgroups.
我们的目的是比较接受过度通气和屏气激发试验的惊恐障碍（PD）患者的人口统计学和精神病理学特征，并描述在两项试验后均出现惊恐发作的患者与在任何一项试验后均未经历惊恐发作的患者的特征。85名PD患者被诱导以每分钟30次呼吸的频率过度通气4分钟，一周后，他们要尽可能长时间地屏气4次，每次间隔2分钟。在试验前后应用焦虑量表。将对两项试验均以惊恐发作做出反应的患者（双阳性组，n = 25）与经历过自发性惊恐发作但对两项试验均未做出惊恐反应的患者（阴性组，n = 16）进行比较。双阳性组在惊恐发作期间出现呼吸道症状的比例显著更高。18名（72.0%）双阳性组患者和6名（37.5%）阴性组患者符合呼吸型PD亚型的标准。双阳性组患者惊恐障碍的起病较晚，且PD的家族患病率较高。我们的数据表明，对过度通气和屏气试验均敏感的PD患者与不受激发试验影响的PD患者之间存在区别。惊恐发作可能是不同类型刺激的最终共同通路，而呼吸试验可能是不同PD亚组的特征。
