Coryell W
Department of Psychiatry, University of Iowa College of Medicine, Psychiatry Research-MEB, Iowa City 52242, USA.
Biol Psychiatry. 1997 Feb 1;41(3):259-63. doi: 10.1016/s0006-3223(97)87457-4.
There is now substantial evidence that an abnormal threshold for suffocation alarm underlies panic disorder. Because this disorder is highly familial, evidence of an abnormal suffocation threshold may be apparent in high-risk individuals before they develop clinical illness. To explore this possibility, we used a single inhalation of 35% CO2 vs. air to evaluate 11 subjects who had at least one first-degree relative with DSM-III-R panic disorder, 13 who had at least two relatives treated for mania or for depression (HR-AD), and 15 low-risk controls who had no family history of panic disorder, affective disorder, or alcoholism (LR-C). All were aged 18-34 and had no history of panics or of any Research Diagnostic Criteria disorder. Five (45.5%) of the subjects at high risk for panic disorder, but none of the LR-C subjects (p = .007), nor any of the HR-AD subjects (p = .011), developed a panic attack following inhalation of the CO2 mixture.
目前有大量证据表明，窒息警报阈值异常是惊恐障碍的基础。由于这种疾病具有高度家族性，窒息阈值异常的证据可能在高危个体出现临床疾病之前就已显现。为了探究这种可能性，我们让11名至少有一位患有DSM-III-R惊恐障碍的一级亲属的受试者、13名至少有两位接受过躁狂或抑郁症治疗的亲属的受试者（HR-AD）以及15名无惊恐障碍、情感障碍或酒精中毒家族史的低风险对照者（LR-C），单次吸入35%的二氧化碳与空气的混合气体进行评估。所有受试者年龄在18至34岁之间，无惊恐发作史或任何研究诊断标准疾病史。吸入二氧化碳混合物后，5名（45.5%）惊恐障碍高危受试者出现了惊恐发作，但LR-C受试者中无人出现（p = 0.007），HR-AD受试者中也无人出现（p = 0.011）。
