Beck J G, Berisford M A, Taegtmeyer H
Department of Psychology, University of Houston, TX 77204-5341.
Behav Res Ther. 1991;29(6):611-21. doi: 10.1016/0005-7967(91)90010-z.
The present investigation was designed to examine panic symptom experience in patients with chest pain of nonorganic etiology, using a hyperventilation provocation procedure. Given the recent focus on panic disorder in patients with nonorganic chest pain, we assessed three indices of physiological arousal, subjective anxiety, and endorsement of DSM-III-R panic symptomatology in response to 3 min of voluntary hyperventilation. Subjects included 23 patients with nonorganic chest pain (CP sample) and matched normal controls (NC sample). The results indicate that hyperventilation produced significant increases in skin conductance, heart rate, and upper trapezious EMG in both CP and NC samples. Despite equivalent levels of physiological arousal and subjective anxiety, the CP sample endorsed a greater number of DSM-III-R panic symptoms relative to the NC sample. Examination of post-hyperventilation symptoms indicated that a greater percentage of the CP sample reported palpitations, nausea, and chest pain when compared with normals. Comparison of CP patients with and without Panic Disorder revealed no significant differences on any measure. The results suggests that hyperventilation plays a role in symptom experience in patients with nonorganic chest pain, although anxiety does not appear central in moderating this effect.
本研究旨在通过过度通气激发程序，考察非器质性病因胸痛患者的惊恐症状体验。鉴于近期对非器质性胸痛患者惊恐障碍的关注，我们评估了在3分钟自主过度通气后，生理觉醒、主观焦虑以及对《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）惊恐症状学认可程度的三项指标。研究对象包括23名非器质性胸痛患者（CP组）和匹配的正常对照组（NC组）。结果表明，过度通气使CP组和NC组的皮肤电导率、心率以及上斜方肌肌电图均显著增加。尽管生理觉醒和主观焦虑水平相当，但CP组认可的DSM-III-R惊恐症状数量相对于NC组更多。对过度通气后症状的检查表明，与正常人相比，CP组报告有心悸、恶心和胸痛的比例更高。对患有和未患有惊恐障碍的CP患者进行比较，发现在任何测量指标上均无显著差异。结果表明，过度通气在非器质性胸痛患者的症状体验中起作用，尽管焦虑在调节这种作用方面似乎并非核心因素。
