Laboratório Pânico e Respiração, Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Instituto de Biofísica Carlos Chagas Filho, UFRJ, Rio de Janeiro, RJ, Brazil.
Braz J Psychiatry. 2020 Aug;42(4):420-430. doi: 10.1590/1516-4446-2019-0717. Epub 2020 Feb 14.
Panic disorder (PD) pathophysiology is very heterogeneous, and the discrimination of distinct subtypes could be very useful. A subtype based on respiratory symptoms is known to constitute a specific subgroup. However, evidence to support the respiratory subtype (RS) as a distinct subgroup of PD with a well-defined phenotype remains controversial. Studies have focused on characterization of the RS based on symptoms and response to CO2. In this line, we described clinical and biological aspects focused on symptomatology and CO2 challenge tests in PD RS. The main symptoms that characterize RS are dyspnea (shortness of breath) and a choking sensation. Moreover, patients with the RS tended to be more responsive to CO2 challenge tests, which triggered more panic attacks in this subgroup. Future studies should focus on discriminating respiratory-related clusters and exploring psychophysiological and neuroimaging outcomes in order to provide robust evidence to confirm RS as a distinct subtype of PD.
惊恐障碍（PD）的病理生理学非常多样化，区分不同的亚型可能非常有用。已知基于呼吸症状的亚型构成了一个特定的亚组。然而，支持呼吸亚型（RS）作为 PD 的一个明确表型的明确亚组的证据仍然存在争议。研究主要集中在基于症状和对 CO2 的反应来描述 RS 上。在这方面，我们描述了 PD RS 中专注于症状学和 CO2 挑战测试的临床和生物学方面。RS 所具有的主要特征症状是呼吸困难（呼吸急促）和窒息感。此外，RS 患者对 CO2 挑战测试的反应往往更为敏感，这会在该亚组中引发更多的惊恐发作。未来的研究应侧重于区分与呼吸相关的聚类，并探索心理生理学和神经影像学结果，以提供有力的证据来确认 RS 作为 PD 的一个明确亚型。
